WELCOME! -- Ridgemoor Swim Club Membership Application AND Release Waiver 2024

Ridgemoor Swim Club Membership Registration and Release Waiver

Please fill out the information for your registration and the release waiver. Thank you!
Household Family Name*
Please list all household members, including yourself, who will use the membership (ie. Parent, Parent, Child (age), Child (age), Child (age), etc.)*
Remember memberships are for household families, people residing in your home, only. *Please email the club if you have questions or special circumstances about who you list here to discuss how to best handle the concern.
Release Waiver 2025

Please read and fill out the Release Waiver. A signed pdf will be downloadable if you'd like to keep for your records. Thank you!
RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT

In consideration of participating in the sport of swimming, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence RIDGEMOOR SWIM CLUB, INC and its owners, directors, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:

1. I acknowledge that the sport of swimming involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, death as a result of drowning or brain damage caused by near drowning; broken bones, torn ligaments or strains as a result of falls on the deck or from a diving board; medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.

2. I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs t o enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

4. I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – a nd bear the costs of – all risks that may be created, directly or indirectly, by any such condition.

5. In the event that I file a lawsuit, I agree to do so solely in the state where Releasees’ facility is located, and I further a gree that the substantive law of that state shall apply.

6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

I acknowledge that the sport of swimming involves known and unanticipated risks which could result in physical or

By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.
Your name

First NameLast Name
Signature*

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Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred phone number*
Please enter a valid phone number.
Additional Phone Number for pool correspondence
Please enter a valid phone number.
Preferred Email*
example@example.com
Additional Email for pool correspondence
example@example.com
Date*

MonthDayYear
Date
PARENT OR GUARDIAN ADDITIONAL AGREEMENT
(Must be completed for participants under the age of 18)
Parent or Legal Guardian Additional Agreement: "In consideration of activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought b y or on behalf of minor or are in any way connected with such participation by minor."
Name(s) of Minor(s)
Parent Name

First NameLast Name
Date

MonthDayYear
Payment Options and Membership Completion

Continue on here to let us know how you wish to make your payments.

Fees included in Corporate Sponsorship Level I am a sponsor of the pool and our membership is included in our sponsorship level. No need to select any other options, just skip to next section.

$ Free

Household / Family Membership - alternative Product Image

Household / Family Membership - alternativeSelect this alternative option only if you want to pay offline for your membership - One Summer Pool Membership for your household. You will pay by check for your $750, writing the check to Ridgemoor Swim Club and then sending or dropping off to Gretchen Rottman, registrar, OR to the dropbox on the brick post at the pool entrance. This option saves the pool the $22 fees charged for your transaction if you used a credit card. (G. Rottman, 2417 Barfield Dr. SE, Grand Rapids, MI 49546)

$ Free

Single Membership - alternative Product Image

Single Membership - alternativeSelect this alternative option only if you want to pay offline for your membership - One Single Pool Membership for one person. You will pay by check for your $475, writing the check to Ridgemoor Swim Club and then sending or dropping off to Gretchen Rottman, registrar, or to the dropbox on the brick post at the pool entrance. This option saves the pool the $14 fees charged for your transaction if you used a credit card. (G. Rottman, 2417 Barfield Dr. SE, Grand Rapids, MI 49546)

$ Free

Gift to pool: Donation for not helping on cleanup days - alternative Product Image

Gift to pool: Donation for not helping on cleanup days - alternativeSelect this alternative option if you'd like to add a donation to your check to cover not helping on cleanup days or for general donation to the pool. Thank you!

$ Free

Household Membership - paying by credit cardSummer Pool membership for your household.

$750.00

Single Membership - paying by credit cardSummer Pool membership for one person.

$475.00

Gift to pool: Credit Card Fees for a household membershipEach transaction using a credit card for a Household Membership encrues fees for the pool to pay. I would like to cover the fees for my Household Membership transaction.

$22.00

Gift to pool: Credit Card Fees for a single membershipEach transaction using a credit card for a Single Membership encrues fees for the pool to pay. I would like to cover the fees for my Single Membership transaction.

$14.00

Gift to pool: Donation for not helping on cleanup days - paying by credit cardThe pool is a club, a community. The Board is hopeful that all members will help with jobs around the club. If your household was unable to participate at a spring cleanup day, please donate to cover costs of needs we will 'for hire'.

$25.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

I'd like to:

Pay online todayWrite a check and submit via mail or the dropbox at the poolSponsor the pool; see my additional form and payment
Note:

**If you selected a pay by check option, make sure to send in your check soon or put in the drop box at the pool for your membership to be valid. The dropbox can be found hiding just behind the brick post to the left of the main entrance. Include your fee, as well as any donation monies for not helping on cleanup days. **If you will pay online today, please add credit card information below and then submit; we are using WorldPay as our online POS. **If you are a sponsor for our pool and membership is included in your level of sponsorship we will know that you have donated. Thank you for also filling out the rest of the member information and waiver for our membership records!
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Ridgemoor Swim Club Membership Registration and Release Waiver

Release Waiver 2025

PARENT OR GUARDIAN ADDITIONAL AGREEMENT

Payment Options and Membership Completion

Note: