Kidder County Swimming Pool Waiver Release Form

Kidder County Swimming Pool Waiver Release Form
PLEASE READ CAREFULLY THE CONTENTS OF THIS FORM BEFORE SIGNING.

Please read this waiver carefully and be aware that in using the Kidder County Swimming Pool (KCSP) aquatics facility, you will be waiving and releasing all claims for injuries you or your party might sustain arising out of use of the KCSP. Further, you agree to care for the facility in a reasonable and prudent manner. I agree to release, indemnify and hold harmless KCSP against any and all claims for loss, damage or injuries which may result from use and participation. I HAVE READ AND FULLY UNDERSTAND THE ABOVE AGREEMENT OUTLINING MY ASSUMPTION OF RISK AND WAIVER AND RELEASE OF ALL CLAIMS.

Further, I agree to comply with all of the KCSP rules. RULES OF CONDUCT ARE BASED OF SAFETY FIRST.
- Children aged 8 years of age or younger must be accompanied by someone 16 years of age or older. The supervising individual must always be with the child(ren), no exceptions.
  - If parents would like to have their child’s swimming ability tested, they can contact the pool manager to set up a time for testing.
  - Only individuals 8 years old and younger who have passed the competency swimming test will be allowed at the pool without someone 16 years of age or older.
  - If a lifeguard doubts a patrons swimming ability, they will ask the individual to perform a swimming test.
- Do not enter the pool if you have a communicable disease or open cut.
- Outside food and beverages are NOT allowed.
- Pool patrons must shower before entering the pool and after the use of toilet facilities.
- Rough play such as dunking, pushing, chicken fights are prohibited.
- No running is allowed on the pool deck or in the locker rooms.
- Animals are not allowed in the aquatic’s facility.
- Persons under the influence of alcohol or any judgement-impairing substances will not be admitted to the facility.
- Smoking or vaping is not allowed anywhere in the aquatic’s facility.
- Swim masks/goggles are allowed in the pool.
- Only one individual on the diving board at a time.
- Kidder County Swimming Pool/Board is not responsible for lost, damaged or stolen items.
- Only authorized personnel are allowed in the pool office area.
- Patrons must use ladders to exit the pool.
- No patrons are allowed on the deck or in the pool after closing.
Kidder County Swimming Pool OPEN BODY SLIDE RULES
- All riders must be 250 pounds or less
- All riders must be at least 44” tall
- Water depth is 3’ 6” to ride the slide you must be able to swim in this depth of water.
- Single user, feet first, sitting up or laying down only! No chain of people whereby you’re holding onto one another, or holding small children while sliding. Absolutely, no head first position down the slide.
- Do not propel yourself onto the slide.
- No running, standing, kneeling, rotating, tumbling or stopping inside the flume. Arms and hands must always remain inside the flume.
- Due to health risks, use of the water slide is not recommended for pregnant women.
- Users are to slide only after splash down area is cleared.
- Absolutely, no diving from the slide.
- No life jackets, loose clothing, jewelry or items in pockets are to be worn/present while sliding.
- All lifeguards and other pool personnel are expected to follow these rules.
- No patrons are allowed under the slide tower, stairs, & flume – this area is
  for staff members only.
Date*

MonthDayYear
Date
By typing my name below, I acknowledge and agree that my electronic signature is the legal equivalent of my handwritten signature. I consent to be legally bound by the terms and conditions outlined in this agreement for the entirety of this year. I further agree that my electronic signature has the same validity and enforceability as a signed hardcopy document.*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parental/ Legal Guardian Consent If Participant is Under The Age of 18
Adult Name

First NameLast Name
Name of Minor

First NameLast Name
Name of Minor

First NameLast Name
Name of Minor

First NameLast Name
Name of Minor

First NameLast Name
Name of Minor

First NameLast Name
I attest that am at least 18 years of age and agree to assume responsibility for the minor(s) named above for the limited purpose of participating in activities at the KCSP.

All swimmers must have a safe, responsible behavior at the KCSP. He/she will be expected to meet all the requirements and adherence to all policies and procedures.

I CERTIFY THAT I HAVE READ, FULLY UNDERSTAND AND AGREE TO THE TERMS OF THIS AGREEMENT, AND I SIGN IT VOLUNTARILY WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE.
YesNo
By typing my name below, I acknowledge and agree that my electronic signature is the legal equivalent of my handwritten signature. I consent to be legally bound by the terms and conditions outlined in this agreement. I further agree that my electronic signature has the same validity and enforceability as a signed hardcopy document.
Date Signed

MonthDayYear
Date
Name of Emergency Contact

First NameLast Name
Emergency Contact (If phone number is different then listed above)
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Kidder County Swimming Pool Waiver Release Form

Parental/ Legal Guardian Consent If Participant is Under The Age of 18