Loading...

YCHS ANNUAL WAIVER

Complete the form below, including all family members who may possibly wish to utilize YCHS facilities and/or register in our classes, camps, programs or activities. Any change to family status will require a new form to be completed. A family is defined as immediate family members permanently living in a household.

COVID-19 WAIVER OF LIABILITY AND INDEMNIFICATION

I agree that I am personally responsible for my safety and actions while using the facilities at YCHS. I agree to comply with all YCHS policies and rules, including but not limited to all YCHS policies, guidelines, signage, and instructions. Because YCHS is open for use by other individuals, I recognize that I am at higher risk of contracting COVID-19. With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue Yorkville Christian High School or business partners, John and Michelle Stewart, Spirit Farms, Stewart Spreading, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors, and assigns from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me related to COVID-19 whether caused by the negligence of the Released Parties, any third-party using the YCHS, or otherwise, while participating in any activity while in, on, or around the YCHS and/or while using any YCHS facilities, tools, equipment, or materials. I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney fees) arising either directly or indirectly from or related to any and all claims made by or against any of the Released Parties due to bodily injury, death, loss of use, monetary loss, or any other injury from or related to my use of the YCHS facilities, tools, equipment, or materials, whether caused by the negligence of the Released Parties or otherwise specifically related to COVID-19. By signing below I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed, including without limitation the Release of Liability and Indemnification requirements contained in this document; I am sufficiently informed about the risks involved in using YCHS to decide whether to sign this document; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same. I agree that this Waiver of Liability shall be governed by and construed in accordance with Illinois law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Waiver of Liability as a whole. This waiver remains in effect until the State of Illinois lifts all COVID-19 related mandates.

WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK

Please read this form carefully and be aware that in signing up and participating in classes, camps, programs, or activities, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all classes, camps, programs, or activities connected with and associated with the classes, camps, programs, or activities (including transportation services, when provided). Yorkville Christian High School (“YCHS”) is committed to conducting its activities in a safe manner and holds the safety of participants in high regard. YCHS continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants' safety. However, participants and parents/guardians of minors registering for classes, camps, programs, or activities must recognize that there is an inherent risk of injury when choosing to participate. You are solely responsible for determining if you or your minor child/ward is physically fit and/or adequately skilled for activities. It is always advisable, especially if the participant is pregnant, disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity. YCHS activities are intended to challenge and engage the physical, mental and emotional resources of each participant. Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury when participating in any recreational activity. Depending on the particular activity, certain risks and dangers may exist due to inclement weather, slips and falls, poor skill level or conditioning, carelessness, horseplay, unsportsmanlike conduct, lack of safety equipment, inadequate or defective equipment, failure in supervision and instruction or officiating, and premises defects. It is impossible for the YCHS to guarantee absolute safety.

I recognize these dangers and acknowledge that there are certain risks of physical injury to participants in the classes, camps, programs, or activities, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with the classes, camps, programs, or activities I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in classes, camps, programs, or activities against YCHS, including its officials, agents, volunteers and employees (hereinafter collectively referred to as "Parties"). I do hereby fully release and forever discharge the Parties from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with classes, camps, programs, or activities . I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. If registering on-line or via fax, my on-line or facsimile signature shall substitute for and have the same legal effect as an original form signature. Photos and video footage are periodically taken of people participating in YCHS classes, camps, programs, or activities while attending a class or event, or using YCHS facilities or property. Please be aware that by registering for classes, camps, programs, or activities, participating in an activity, attending an event, or using YCHS facilities or property, you authorize YCHS to use these photos and video footage for promotional purposes in YCHS publications, advertising, marketing materials, brochures, event flyers, social media (including Facebook, YouTube, Instagram, Twitter, and other social media sites operated by the YCHS), and the YCHS website without additional prior notice or permission and without any compensation to you. All photos and videos are property of the YCHS. It is understood that this Annual Waiver shall be applicable, including the waiver and release of all claims, for participation in classes, camps, programs, or activities for a period of one year. I have carefully read the Insurance Liability Waiver on this form and understand that my signature is required below in order for myself or my child/ward to participate in YCHS classes, camps, programs, or activities.

Today's date: November 21, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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 the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

CURRENT GRADE

CURRENT SCHOOL

GROUP YOU ARE USING THE FACILITY WITH *
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written 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 that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!