LUNDA COMMUNITY CENTER

Membership Agreement and Hold Harmless Waiver

405 Highway 54 W Black River Falls, WI 54615

**Please note that in order to purchase a membership you must visit the Lunda Community Center in person.

List all additional family members included under this membership: (A family membership is defined as a maximum of two adults with a maximum of 6 dependents up to the age of 25 living in the same house.)

I assume full responsibility for any minors in my charge, ages 17 and under. Members ages 11 and under need to be directly supervised by their parent/guardian/adult while in attendance at the Lunda Community Center and it is the responsibility of that supervising parent/guardian/adult to keep them safe, ensure that they show respect to people and property, and use the facility responsibly. Members ages 12 to 17 years of age MUST have a Release and Hold Harmless Waiver signed by a parent/ legal guardian ON FILE in order to gain access to the Lunda Community Center; without this form, the minor WILL NOT be allowed access to the Lunda Community Center.

Members ages 12 and over may utilize the Lunda Community Center without direct adult supervision, however they may be asked to leave if guidelines regarding respect, responsibility and safety as written in the Lunda Community Center Member Code of Behavior, or as verbally directed, are not followed. Members must be 15 years or older to utilize the Fitness Center OR 14 years old and have taken the Intro to Fitness Class OR be directly supervised by an adult while in the Fitness Center. Minors age 13 and under are NOT permitted to use the fitness equipment in the Fitness Center. Members must be age 12 years and older to utilize the Aquatic Center (Water Park & lap pool) unsupervised during Water Park Hours (Lifeguards on duty Members age 11 and under must be directly supervised by a parent/guardian/adult while in the Aquatic Center during Water Park Hours (Lifeguards on duty Members must be 18 years and older to utilize the lap pool during Adult Open or Adult Lap Swim Hours (No Lifeguards on duty I understand that cell phones, tablets, computers, and other electronic recording devices are not allowed to be used in

By accepting a locker, members shall be deemed to have consented to its periodic inspection. Canines that have been trained in the detection of unlawful drugs or explosives may be used to assist in periodic inspections of lockers. Accompanying this document is the Lunda Community Center Member Code of Behavior. It is also available at the Lunda Community Center Front Desk. It addresses respect, responsibility and safety guidelines for members.

Attention: Please read the following carefully. This waiver affects you and your family's legal rights. In consideration for being permitted to utilize (as a member, participant, guest or volunteer) the facilities, services and programs of the Lunda Community Center for any purpose (including, but not limited to observation or use of facilities or equipment, or participation in any program or event affiliated with the Lunda Community Center, without respect to location) the undersigned, for him/herself, any personal representatives, heirs, successors and assigns, 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. I understand that participating in activities, as a participant, volunteer, or observer, exposes me to a risk of property damage, personal injury or death. I understand that my choice of participating in activities is voluntary on my part, and I affirm my desire to participate in the program or activity. I agree to assume full responsibility for my safety, the safety of my family and guests, and the safety of my property while I am in, or at, the Lunda Community Center or an event or program affiliated with the Lunda Community Center, without respect to location. I understand that I may sometimes participate in various activities, some of which may include an element of risk, and further acknowledge that Lunda Community Center activities and events will not always be supervised. This waiver includes any and all activities associated with, and sanctioned by, the Lunda Community Center whether taking place on or off our main location, 405 State Highway 54W, Black River Falls, WI 54615. I acknowledge that I am aware of the risks and exposure both directly and indirectly arising out of, contributed to, by, or resulting from any and all viruses and/or diseases, including but not limited to, the virus "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)", which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or a variation thereof. In consideration of having the opportunity to participate in activities offered by the Lunda Community Center, and in acknowledging that I am aware of and willing to assume the risks associated with this activity, I, the undersigned, and my Parent/Guardian, if applicable, do hereby voluntarily release, indemnify, and hold harmless the LUNDA COMMUNITY CENTER, it's directors, board members, employees and volunteers from any and all liability claims, demands, costs, expenses, and actions of any nature (including suing) whatsoever arising out of or related to any loss, damage, or injury, including death, which may be sustained by me, any members of my family, guests of any age, or property, whether or not caused by any negligence, either active or passive, by or on behalf of the Lunda Community Center. The terms hereof shall also serve as a release and assumption of risk for my heirs, successors, assigns, executor and administrator, and for all members of my family, and may be pleaded as a bar to litigation. If any portion of this agreement is deemed by a court of competent jurisdiction to be against public policy or unenforceable, then only that wording is removed from the agreement, and the rest of the waiver

I am 18 years of age or older (or my Parent/Guardian is also a signatory herein) and have read the Membership Agreement and Release and Hold Harmless Waiver and understand and voluntarily accept the terms. All household members 18 years of age & older must sign below.

Additional Adult Signature (Additional household members 18+ may sign in person at the LCC.)