Pool Guest Registration Form

Which pool are you and your guests attending?*

Heartland Parkway PoolThe Oasis Pool

How many guests are attending with you?*

1234

Date*

Date

Resident Heartland Address*

Street Address

Street Address Line 2

Resident (Cardholder) Full Name*

First NameLast Name

Resident (Cardholder) Access Card #*

Guest #1 Full Name*

First Name, Last Name

Guest #1 Age*

Guest #2 Full Name

First Name, Last Name

Guest #2 Age

Guest #3 Full Name

First Name, Last Name

Guest #3 Age

Guest #4 Full Name

First Name, Last Name

Guest #4 Age

Heartland - COVID-19: Pool & Fitness Facilities

RELEASE, WAIVER OF LIABILITY, INDEMNITY AND ASSUMPTION OF RISK

Due to COVID-19 Concerns and Various Directives from Municipal and State Authorities, Use of the Fitness Facilities Will Only be Allowed After You Sign this Release.

I understand COVID-19 is an easily transmittable and contagious virus and there are no known measures to insulate myself from infection. I also understand that any insurance maintained by the owner and operator of the fitness facilities will likely not provide coverage for bodily injury, including permanent disability, paralysis, and death, resulting from infection by the COVID-19 virus. By entering and using the fitness facilities I am knowingly and voluntarily subjecting myself to possible exposure to the COVID-19 virus and the consequences thereof. I will undertake all reasonable measures to protect myself and others who use the fitness facilities from exposure or infection. I fully understand that the use of the fitness facilities may involve risks of serious bodily injury, including permanent disability, paralysis, and death, caused by contraction of the COVID-19 virus due to: (i) my actions, or inactions, (ii) the actions or inactions of third-parties using the fitness facilities, and (iv) the actions or inactions of the Heartland Community Association, Inc. (collectively, the "Risks"). I fully understand, accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of such Risks.

I understand COVID-19 is an easily transmittable and contagious virus and there are no known measures to insulate myself from infection. I also understand that any insurance maintained by the owner and operator of the pool and related facilities will likely not provide coverage for bodily injury, including permanent disability, paralysis and death, resulting from infection by the COVID-19 virus. By entering and using the pool and related facilities I am knowingly and voluntarily subjecting myself to possible exposure to the COVID-19 virus and the consequences thereof. I will undertake all reasonable measures to protect myself and others who use the pool and related facilities from exposure or infection. I fully understand that the use of the pool and related facilities may involve risks of serious bodily injury, including permanent disability, paralysis and death, caused by contraction of the COVID-19 virus due to: (i) my own actions, or inactions, (ii) the actions or inactions of third-parties using the pool and related facilities, and (iv) the actions or inactions of the Heartland Community Association, Inc. (collectively, the"Risks"). I fully understand, accept and assume all such Risks and all responsibility for losses, costs, and damages I incur as a result of such Risks.
In consideration of being allowed to use the pool and related facilities, on my behalf and on behalf of my heirs, representatives and assigns, I hereby release, forever discharge, and covenant not to sue the Heartland Community Association, Inc., UST-Heartland, LP, UST-Heartland GP, LLC, Huffines Communities, Inc. and Huffines Management Partners, LP, its respective directors, officers, agents, employees and contractors (collectively, the "Releasees") from all liability, claims, demands, losses, or damages suffered by me on my account of, or alleged to be caused, in whole or in part, by the negligence or gross negligence of the Releasees or otherwise, resulting in my exposure to or infection by the COVID-19 virus. I further warrant, covenant and agree that the release, waiver and assumption of the risk contained herein shall be binding on anyone who makes a claim against any of the Releasees on my behalf or resulting from injuries which I may incur or suffer. I further agree to INDEMNIFY AND HOLD THE RELEASEES HARMLESS from any claim asserted by or on behalf of my family members or any of my guests based on facts or circumstances encompassed by the Risks.

In further consideration of being allowed to use the pool and related facilities, I hereby affirm that neither I nor any of my family members: (i) have a cough, fever, shortness of breath, or (ii) have been sick in the past 2 weeks or exposed to someone who has been sick in the past 2 weeks.

My family members and I, including our guests, agree to practice preventative actions issued by the CDC to prevent the spread ofCOIVD-19 including, but not limited to, maintaining physical distance of at least 6 feet between persons.

I have read this RELEASE, WAIVER OF LIABILITY, INDEMNITY AND ASSUMPTION OF
RISK, 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. Any violation of the Association's Rules is subject to immediate removal and suspension of privileges.

I understand that guests must remain with me, the cardholder, at all times during the duration of the visit.

Signature*

Heartland Pool Guest Access Form