2024 Waiver

This Swim Waiver needs to be signed once a year.
2023 ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT In consideration of being allowed to participate on behalf of Lessons from a Lifeguard Swim school and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce the risk, the risk of serious illness and death does exist; and,
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2. I, MYSELF AND/OR CHILDREN, WILL NOT COME TO CLASS IF ANYONE IN THE HOUSEHOLD HAS A FEVER, RUNNY NOSE OR COUGH; and,
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3. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation; and,
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4. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If I, however, observe any unusual or significant hazard during my presence or participation and bring such to the attention of the nearest official immediately; and,
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5. People considered to be at a higher risk for contracting illnesses should not participate in such activities where a communicable illness may be present and therefore will require a medical statement signed by a licensed physician; and,

a. I acknowledge being considered “high risk” are those people with chronic lung disease or moderate to severe asthma, have serious heart conditions, severe obesity (body mass index [BMI] of 40 or higher), with diabetes, chronic kidney disease undergoing dialysis, liver disease, or are immunocompromised (Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications).
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6. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Lessons from a Lifeguard their officers, officials, agents, and/ or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASES OR OTHERWISE, to the fullest extent permitted by law.
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7. In consideration of your acceptance for enrollment in the Lessons from a Lifeguard Swim Program, I, my heirs, executor and administrator agree that you are aware and understand that activities involving Swimming, are dangerous and involve risk of drowning, serious injury and/ or death. I acknowledge that I am voluntarily participating in the activities with the knowledge of the dangers involved and hereby accept and assume any and all risks of injury including death, even if arising from the negligence of the releases.
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8. I expressly waive and release and all claims against Lessons from a Lifeguard and its owners, managers,
officers, employees, agents, affiliates, successors, and assigns (collectively, releases), on account of injury or death arising out of or attribute to my participation in the activities. Whether arising out of the negligence of the Lessons from a Lifeguard or any releases or otherwise. I covenant not to make or bring any such claim against Lessons from a Lifeguard or any other release and forever release, discharge and hold Lessons from a Lifeguard and other releases harmless from liability under such claims.
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9. I hereby authorize any representatives of Lessons from a Lifeguard to have the participant treated in any medical emergency during his/her participation in the activities. Further, the participant and/ or parent/ guardian agrees to pay all costs associated with medical care for and transportation of the participant. I have notified Lessons from a Lifeguard of any medical/health problems of which the Lessons from a Lifeguard staff should be aware prior to participating in the Swim Program.
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I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHT BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releases and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releases for any and all liabilities incident to my minor child's/ward's presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

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Please fill in the information for who will be participating.

Options are: Adult's, Minor’s, or, fill out both for Mommy & Me classes.

If you are enrolling for siblings or a group lesson, one parent can sign for all participating Minors.

Adult's Name

First NameLast Name

Adult's Date of Birth

First Minor's Name

First NameLast Name

First Minor's Contact Phone Number

Please enter a valid phone number.

First Minor's Date of Birth

Second Minor's Name

First NameLast Name

Second Minor's Contact Phone Number

Please enter a valid phone number.

Second Minor's Date of Birth

Third Minor's Name

First NameLast Name

Third Minor's Contact Phone Number

Please enter a valid phone number.

Third Minor's Date of Birth

Fourth Minor's Name

First NameLast Name

Fourth Minor's Contact Phone Number

Please enter a valid phone number.

Fourth Minor's Date of Birth

Allergy and/or Medical Conditions

Please list name(s) and condition(s)

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 terms of this document, as set forth above.

Parent or Guardian’s Name*

First NameLast Name

Parent or Guardian’s Email Address*

This email will be used to receive updates about Swim Lessons. We respect your privacy- we will never sell your info or spam you.

Signature*

Electronic Signature Consent*

By initialing here, you are consenting to the use of your electronic siganture in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By initialing here, you are waiving that right. After consent, you may, upon 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 we have a current email address in order to contact you regarding any changes, if necessary. Lastly, please be informed of the no refund policy.

2024 Lessons from a Lifeguard Swim Waiver