IN CONSIDERATION of being permitted to utilize the facilities, services and programs of the YMCA AND THE CITY OF NOVATO for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site program affiliated with the YMCA AND THE CITY OF NOVATO, the undersigned, for himself or herself and any personal representatives, heirs, and next of kin, hereby acknowledges, agrees and represents that he or she has, or immediately upon entering or participating will, inspect and carefully consider such premises and facilities or the affiliated program. It is further warranted that such entry into the YMCA AND THE CITY OF NOVATO for observation or use of any facilities or equipment or participation in such affiliated program constitutes an acknowledgment that such premises and all facilities and equipment theron and such affiliated program have been inspected and carefully considered and that the undersigned finds and accepts same as being safe and reasonably suited for the purpose of such observation, use or participation.
IN FURTHER
CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA AND THE CITY OF NOVATO FOR
ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR
EQUIPMENT, OR PARTICIPATION IN ANY OFF-SITE PROGRAM AFFILIATED WITH THE YMCA
AND THE CITY OF NOVATO, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:
1. THE UNDERSIGNED
HEREBY RELEASES, WAIVES, DISCHARGES AND CONVENANTS NOT TO SUE the YMCA AND THE
CITY OF NOVATO, its directors, officers, employees, and agents (hereinafter
referred to as “releasees”) from all liability to the undersigned, his personal
representatives, assigns, heirs, and next of kin for any loss or damage, and
any claim or demands therefor on account of injury to the person or property or
resulting in death of the undersigned, whether caused by the negligence of the
releasers or otherwise while the undersigned is in, upon, or about the premises
or any facilities or equipment therein or participating in any program
affiliated with the YMCA AND THE CITY OF NOVATO. 2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY
AND SAVE AND HOLD HARMLESS the releasees and each of them from any loss,
liability, damage or cost they may incur due to the presence of the undersigned
in, upon or about the YMCA AND THE CITY OF NOVATO premises or in any way
observing or using any facilities or equipment of the YMCA AND THE CITY OF
NOVATO or participating in any program affiliated with the YMCA AND THE CITY OF
NOVATO whether caused by the negligence of the releasees or otherwise. 3. THE UNDERSIGNED HEREBY ASSUMES FULL
RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to
negligence of releasees or otherwise while in, about or upon the premises of
the YMCA AND THE CITY OF NOVATO and/or while using the premises or any
facilities or equipment thereon or participating in any program affiliated with
the YMCA AND THE CITY OF NOVATO.
THE UNDERSIGNED
further expressly agrees that the foregoing RELEASE, WAIVER AND INDEMNITY
AGREEMENT is intended to be as broad and inclusive as is permitted by the law
of the State of California and that if any portion thereof is held invalid, it
is agreed that the balance shall, notwithstanding, continue in full legal force
and effect.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement have been made.
Signature of applicant/parent: __________________________________________________ Date: ________________________
Print name of
applicant/parent: _________________________________________________ Date: ________________________