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CHILD CARE AUTHORIZATION - ANIMAL INTERACTION PROGRAMS RELEASE AND LIABILITY WAIVER  

TODAY'S DATE: March 28, 2024

I recognize and acknowledge that Theater of the Sea's ("TOTS") Animal Interaction Program(s) are vigorous physical activities that involve risks of personal physical and emotional injury as well as possible damage to my property. Examples of these injuries include, but are not limited to, bruises, scrapes, abrasions, sprains, broken bones, fear, stress, skin irritations caused by irritants in the water, and other physical and emotional trauma and property damage. I acknowledge that these examples do not include all possible injuries and that there may be additional potential risks involved both known and unknown. I fully understand the potential risks of being a participant in the Animal Interaction Program(s) and hereby assume all such risks in any way arising from or connected with the Animal Interaction Program(s)

I acknowledge that any woman who may be pregnant is NOT permitted to be a participant in the Swim with the Dolphin, Wade with the Dolphin, or Swim with the Sea lion Programs
I further certify to TOTS all of the following:

I am in good physical health, physically fit to be a participant and have no illness, disability, injury, or any physical or emotional condition that could in any way interfere with my being a participant or prevent my safe participation in any Animal Interaction Program(s).
I am comfortable in deep water.
I am not under the influence of alcohol or any drug or medication that may prevent my safe participation in any Animal Interaction Program(s).
I have not been involved in any marine mammal rescue effort within the past forty-eight (48) hours. 

In consideration for my being permitted to participate in the Animal Interaction Program(s) checked above and for being invited upon the TOTS premises, I hereby covenant and agree that Theater of the Sea, its owners, parents, subsidiaries and affiliated companies and their respective assignees, officers, directors, shareholders, employees and agents (the "Released Parties") shall not be liable for any and all liabilities, damages and claims (including without limitation, compensatory damages, punitive and exemplary damages and damages for pain and suffering), losses or expenses arising from personal injuries or damages to property which I may incur resulting from or arising out of my participation in the Animal Interaction Program(s), or as a result of my presence in any capacity on TOTS' premises, whether or not arising from the negligent action or inaction of any of the Released Parties. I hereby covenant and agree not to sue any of the Released Parties (or file a claim with any of their insurance providers) for any and all claims, demands, I liabilities, damages, rights of action or causes of action, present or future, of any kind or nature, whether known or unknown, anticipated or unanticipated, resulting from or arising out of my participation in the Animal Interaction Program(s) or as a result of my presence in any capacity on TOTS' premises, whether or not arising from the negligent action or inaction of any of the Released Parties.
I also agree that I am responsible for any injuries or damages to any person(s) or property located at TOTS caused by my actions while I am or was present at TOTS.
I acknowledge and agree that if any provision or part of this Release form shall be determined to be void by any court of competent jurisdiction, then such provision or part may be severed from this release form and such determination shall not affect any other provision or part of this Release form. If any provision or part of this Release form is capable of two constructions, one of which would render the provision or part void and the other of which would render the provision or part valid, then the provision or part shall have the meaning which renders it valid. This Release form shall be governed by Florida law.
If more than one person signs this Release, each person is fully and personally responsible for all of the statements and certification made in this Release and is full and personally obligated to keep all of the promises made in this Release. 

I understand and agree that as a condition of participation in the Animal Interaction Program(s), I am required to attend the pre swim orientation where all rules and regulations regarding my participation will be fully explained. It is my responsibility to have any questions answered to my satisfaction and understanding prior to entering the program. I also acknowledge and agree that if I fail to follow the rules and instructions, I will be removed from the Animal Interaction Program(s) with no refund. I have read and agree to abide by the rules as outlined on the reverse side of this form.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Child Care Authorization Form

For Animal interaction programs, liability waivers must be signed by a parent or appointed guardian prior to participation. Any appointed guardian must provide notarized documentation of guardianship. You can use this form and it must be filled out entirely.

I,


Name of Parent or legal Appointed Guardian *

 the undersigned parent of


Minor's full name *

Hereby grant


Name of temporary guardian *

temporary guardianship for the child named above.

This grant of temporary guardianship shall begin on


Click to customize date box label *

and remain in effect until 


Click to customize date box label *

The above named guardian shall have the power to: Select all that apply

Seek appropriate medical treatment or attention on behalf of the child as may be required by the circumstances, including but not limited to, medical doctor and / or hospital visits.
Authorize medical treatment or medical procedures in an emergency situation
Sign any releases to authorize participation in any Animal Interaction Program activities at Theater of the Sea. Not limited to the Dolphin Swim
Assume guardianship for all of the above purposes and associated activities that may pertain thereto without limitation.

Please not that (print child name) has a specific medical condition or allergy: Described as: 


Medical conditions or allergies
ANIMAL INTERACTION PROGRAM RULES

ANIMAL INTERACTION PROGRAM RULES

The instructor is in charge at all time, participants must follow instructions.  No one else should give instructions, this include parents, observers, and other participants.

If at any time we feel a person is adversely affecting the animals, other participants, and/or smooth operation of the program, that person will be asked to leave the program.

If an animal behaves in a way that makes you uncomfortable, inform the trainer.

In compliance with regulations, our programs are controlled.

This means the animals are trained and an experienced instructor directs any and all interaction between the human and animal participants.

Program content can be modified depending on the staff, the animals, and the participants.

We do not do every behavior every program.

Should you have any requests regarding the content of your program, speak with us prior to your interaction.

Participants take turns interacting with the animals, giving them a signal requesting a specific behavior. 

We will go over the signal for each behavior at poolside.

Proper signals are mandatory.

Do not give the animals signals or request any behaviors unless instructed to do so.

Public interaction time with the animals is regulated.

If you wish to maximize your time with the animals, listen carefully to directions and if you are swimming, remain in the water once the program starts.

Observers are not allowed contact with the animals, nor are they allowed access to the water, platforms, or boardwalks.  Please remain and take photographs from designated areas. 

For the smooth and safe operation of the program, animal care staff are not permitted to take photographs while conducting the program. 

However, if Theater of the Sea photographers are at your program, photos will be available in the main building.

In Water Programs Only-Dolphin Swim and Wade, Sea Lion Swim, Shark and Ray Swim

·  Do not jump or dive into any pool!  This may startle the animals

·  To enter and exit the water, walk in from the beach or use the stairs.

·  Stairs may be slippery so hold onto the railing anytime you enter or exit the pool.

·  Be careful not to stir up sand on the beaches so as not to affect visibility.

Fins (dolphin swim) or water shoes (shark and ray swim) are required. 

Masks are optional if you wish to view the animal under water.

No materials or objects other than fins, masks, snorkels, water shoes, and underwater cameras may be taken into the pool without approval.  Any item the animals could swallow could compromise their health.  Please...

·  give rubbers bands from disposable cameras to instructors,

·  if you not done so already, please remove jewelry and store securely,

·  remove any change or items from your pockets and store securely,

·  do NOT remove snorkels from masks or you risk losing the snorkel keeper,

·  do NOT remove wristbands...we collect these from you after the program.

Since observers are at the pool's edge, be especially careful with sunglasses, camera lens caps, children's toys and pacifiers, etc that could fall into the pool. 

Dolphin Swim, Wade, Meet, Paint, Sea Lion Swim, Meet, Paint, Crocodile Meet, Shark Swim

We feed and interact with the animals from an area called a station that is indicated with a food bucket. 

·  Participants must keep five feet away from the animal's station and food buckets at all times. 

·  Do not touch the animals while they are being fed.

·  If they drop food, leave it. 

Dolphin Swim, Wade, Meet, Paint, Sea Lion Swim, Meet, Paint, Sea Turtle Meet, Shark and Ray Swim

When touching the animals:

·  let the animal initiate the contact, do not chase the animal

·  use only an open handed rub....do not pat, scratch, hold onto, or grab the animal

·  rub only where shown and not the face

Dolphin Swim only

We will let you know exactly when to do each behavior, including the dorsal tow. 

In accordance with regulation, while swimming with the dolphin, DO NOT HOLD ONTO THE DORSAL FIN AT ANY TIME EXCEPT UNDER OUR INSTRUCTION. (demonstrate the proper way to hold onto the dorsal fin for single dorsal tow only).

Crocodile and Sea Turtle Meet, Shark and Ray Swim

Correct and safe feeding as explained must be used and participants must clean their hands before and after program. Do not throw food because it attracts birds.

Shark and Ray Swim

It is extremely important that you stay calm.  The sharks/rays may rub up against you and/or bump into you.  If this happens, please do not panic. 


THANK YOU and ENJOY YOUR INTERACTION WITH THE ANIMALS! 

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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