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TUTORIAL APPLICATION

Birthday
Month
Day
Year
Preferred 2026/27 Tutorial Day
Tuesday
Wednesday
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Friday
Second Choice: 2026/27 Tutorial Day
Tuesday
Wednesday
Thursday
Friday
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Does your son have any siblings?
Yes
No

 Release and Indemnity Agreement (''Agreement'') for Related Events, Field Trips & Activities (“Activity”)


I represent that I will understand the nature of an Activity and be sure that my son is qualified, in good health, and in proper physical condition to participate in such Activity.


I acknowledge that if I believe conditions are unsafe for my son/daughter, I will immediately discontinue my sons’/daughters' participation in the Activity.


I fully understand that an Activity can involve risks of serious bodily injury, which may be caused by my son/daughter's actions, or others’ actions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the ''releasees'' named below; and that there may be other risks either not known to me or not readily foreseeable at this time.


I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my son participation in the Activity.


I hereby release/discharge/covenant not to sue The Riverside Club for Adventure & Imagination, NFP/its respective administrators/directors/agents/officers/volunteers/employees/other participants/owners or lessors of premises on which the Activity takes place, (each considered one of the ''RELEASEES'' herein) from all liability/claims/demands/losses/damages on my account caused/alleged to be caused in whole/in part by the negligence of the ''releasees''/or otherwise, including negligent rescue ops.


I further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.


I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.nd Indemnity Agreement (''Agreement'') for Related Events, Field Trips & Activities (“Activity”)


I represent that I will understand the nature of an Activity and be sure that my son is qualified, in good health, and in proper physical condition to participate in such Activity.


I acknowledge that if I believe conditions are unsafe for my son/daughter, I will immediately discontinue my sons’/daughters' participation in the Activity.


I fully understand that an Activity can involve risks of serious bodily injury, which may be caused by my son/daughter's actions, or others’ actions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the ''releasees'' named below; and that there may be other risks either not known to me or not readily foreseeable at this time.


I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my son participation in the Activity.


I hereby release/discharge/covenant not to sue The Riverside Club for Adventure & Imagination, NFP/its respective administrators/directors/agents/officers/volunteers/employees/other participants/owners or lessors of premises on which the Activity takes place, (each considered one of the ''RELEASEES'' herein) from all liability/claims/demands/losses/damages on my account caused/alleged to be caused in whole/in part by the negligence of the ''releasees''/or otherwise, including negligent rescue ops.


I further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.


I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

I/we consent to photographs and videos of my family taken during Riverside events or programming being used for Riverside promotional purposes, including but not limited to on the website, in print materials, emails, and social media.
Yes
No

When you click submit, you will be taken to a payment processing page. Your son's Tutorial spot is not secured until you pay the $250 non-refundable deposit. (This amount will apply towards Tutorial tuition.)

Deposit Amount (Non-Refundable)
$250

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March 2026

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49W226 Jericho Road

Big Rock, IL 60511

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