Please read and sign
below to use Club Facilities - Facility Agreement & Release of Liability
1. In consideration of gaining membership or being allowed to
participate in the activities and programs of The Club at River Wilderness and
to use its facilities, swimming pool, equipment, and machinery, in addition to
the payment of any fee or share, I do hereby waive, release and forever
discharge The Club at River Wilderness and its officers, agents, employees,
representatives, executors, and all others from any and all responsibilities or
liability for injuries or damages resulting from my participation in any
activities or my use of equipment or machinery in the above-mentioned facilities
or arising out of my participation in any activities at said facility. I do
also hereby release all of those mentioned and any others acting upon their
behalf from any responsibility or liability for any injury or damage to myself,
including those cause by the negligent act or omission of any of those
mentioned or others acting on their behalf or in any way rising out of or
connected with my participation in any activities of The Club at River
Wilderness or the use of any equipment at The Club at River Wilderness.
2. I understand and am aware that swimming, strength,
flexibility, and aerobic exercise, including the use of the pool and equipment,
is a potentially hazardous activity. I also understand that fitness and sports
activities involve a risk of injury and even death and that I am voluntarily
allowing my child(ren) to participate in these activities and use the pool,
equipment, and machinery with knowledge of the dangers involved. I hereby agree
to expressly assume and accept any and all risks of injury or death.
3. I do hereby further declare that my child(ren) are
physically sound and suffering from no condition, impairment, disease
infirmity, or other illness that would prevent their participation in any of
the activities and programs of The Club at River Wilderness or use of the pool,
equipment or machinery except as hereinafter stated. I do hereby acknowledge
that I have been informed of the need for a physician’s approval for my
child(ren)’s participation in an exercise/fitness activity, exercise, and use
of exercise and training equipment so that I might have recommendations
concerning these fitness and sports activities and equipment use. I acknowledge
that he/she has had either a physical examination and/or been given physician’s
permission to participate, or that I am allowing them to participate in all
fitness and sports activity and/or use of equipment and machinery without the
approval of their physician and do hereby assume all responsibility for their
participation in any and all fitness and sports activities, and utilization of
equipment and machinery and activities.
4. I do hereby further declare myself that I am the legal
parent and/or the legal guardian of the child(ren) I am authorizing to
participate in these fitness and sports activities.
I, the undersigned, do hereby acknowledge, accept and
understand that I have truthfully and to the best of my ability answered all application questions. Further, I agree to
observe and be bound by the Rules & Regulations of The Club at River
Wilderness in the present form or as may be amended. I acknowledge, accept and
understand that I am personally liable and responsible for all financial
obligations relating to my child’s membership in the Summer Camp Activities of
The Club at River Wilderness. In the
event The Club at River Wilderness has to seek the collection of delinquent
charges, I will be obligated to pay The Club at River Wilderness the amount
owed as well as attorney fees and costs incurred in the collection of said
amount.
Please sign name below: