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HEARTLAND COMMUNITY ASSOCIATION, INC.

WAIVER AND RELEASE

MINORS 14-17

In an effort to promote a safe environment for all owners, residents, and guests, and to minimize risk to the Heartland Community Association, Inc. (the “Community Association”), Community Association Management, the Association’s management company (“CCMC”), requests your support and cooperation by reading and signing the following Waiver and Release.

I voluntary choose to use any or all of the facilities and participate in programs offered by the Community Association, including, but not limited to, fitness areas, swimming pools, clubhouse (collectively, the “Facilities”), and participate in activities and events sponsored from time to time by the Community Association (collectively, the “Events”). In consideration for being allowed to use the Facilities and participate in the Events (collectively, the “Amenities”), I declare as follows: 

1)   I understand that each individual (including myself) has a different capacity for participating in and using the Amenities. I assume full responsibility during and after my participation for my choices to use or apply, at my own risk, any portion of the information or instruction I receive. I have read and agree to comply with the written rules and regulations for use of the Amenities.

2)   I understand that part of the risk involved in undertaking any activity or program is contingent on my own state of fitness or health (physical, mental or emotional) and to the awareness, care and skill with which I conduct myself in that activity or program. I acknowledge that my choice to participate in any activity or programs offered or made available by the Community Association brings with it my assumption of those risks or results stemming from this choice, and the fitness, health, awareness, care and skill that I possess and use. I represent to the Community Association that I am physically sound and suffering from no condition, impairment, disease, infirmity or other illness that would prevent my participation in any of the Amenities, including the use of equipment or machinery.

3)   I understand that participating in or use of the Amenities may involve risks, including economic loss, health, disabilities or death, and I willfully and voluntarily assume those risks. I will only use equipment that I know how to operate and use safely. I will not undertake any activity for which I do not feel sufficiently prepared or able. I will take all reasonable precautions to avoid injury to myself and to others and damage to property.

4)   I accept personal responsibility always to act in a safe manner and to abide by the rules and regulations of the Community Association. I agree to stop participating in any activity if I observe any unsafe conditions or broken equipment, or if I experience any pain, discomfort and/or other symptoms that I may suffer during or after participating in the activities. I understand that I may stop or delay my participation in any activity or program if I so desire and that I may also be requested to stop and rest by an employee or agent of the Community Association who observes any symptoms of distress or abnormal response, and I agree to comply with such directions.

By signing this Waiver and Release, I confirm that I have voluntarily chosen to use and participate in the Amenities. I assume all risks to my health as a consequence thereof and, on behalf of myself, my heirs, beneficiaries, dependents and personal representatives, hereby RELEASE, HOLD HARMLESS, WAIVE, FOREVER DISCHARGE, AND COVENANT NOT TO SUE the Heartland Community Association, Inc., CCMC, UST-Heartland, LP, UST-Heartland GP, LLC, Huffines Communities, Inc., Huffines Enterprises, Inc., and Huffines Management Partners, LP, their respective directors, officers, agents, employees and contractors (collectively, the "Releasees") from any responsibilities, liabilities, damages, or claims related to my use of or participation in the Amenities, including the negligence or gross negligence of the Releasees, and 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 involving the use of or participation in the Amenities.  

Owners and/or residents are responsible for the conduct of their guests. Owners and/or residents and their guests shall not reprimand nor discipline any employee or agent of the Community Association. Community Association employees or agents will inform owners, residents or guests of any violation of the rules and regulations of the Community Association, and, when necessary, report such actions to the Board of Directors of the Community Association.

I have read and understood the contents of this Waiver and Release and have had the opportunity to consult with an attorney of my choosing prior to placing my signature below.

PHOTO RELEASE FORM

I hereby expressly grant HEARTLAND COMMUNITY ASSOCIATION, INC. and HUFFINES COMMUNITIES, INC. and their subsidiaries and affiliated communities, and their employees, officers, representatives, licensees, agents, and assigns (all of which are referred to herein as “the Companies”), the unlimited worldwide right, permission, and license to the use of my name, physical likeness (as the same may appear in any still camera photography, videotape recording, motion picture film, electronic representation and/or sound recordings made of me), and voice in connection with the creation of video media and exhibition of said media on television, cable, satellite, internet, live event, or otherwise, without compensation or prior notice to me from the Companies. Permission is granted to use all or any part of said reproduction and to edit them as deemed necessary in the sole discretion of the Companies for print, publication, theatrical motion pictures, or from other mediums.

I hereby waive any inspection or approval of the finished advertisement, and I release the Companies from any liability for any claim of alteration, optical illusion, or faulty mechanical reproduction, and likewise with respect to any distortion or illusion in reproduction.

I hereby certify that and represent that I have the read and understood the foregoing and fully understand the meaning and effect thereof.



First Minor's Name
First Name*
Last Name*
First Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
First Minor's Signature*
Second Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Third Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Fourth Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Fifth Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Sixth Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Seventh Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Eighth Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Ninth Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Tenth Minor's Name
First Name*
Last Name*
Minor's Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Proof of Age - REQUIRED FOR ALL MINORS

Mobile credentials will be emailed to all completed and approved residents of Heartland once the waiver is reviewed (within 24-48 hours, or on the next business day if submitted over the weekend). Emails will come from Sentry Security Solutions (please check your spam/junk folder for this email). Credentials will be texted if a backup is needed after emails are unsuccessful. 

To obtain an access card, all minor residents must provide proof of age using a government-issued identification document. Acceptable forms of ID include: birth certificate, passport, state-issued ID card, or driver's license. Alternatively, you can access Skyward, navigate to "Student Info," take a screenshot of the page displaying the minor's date of birth, and submit as proof of age.to customize text

*
  
Valid file types: JPG, GIF, PNG, and PDF
Facility Rules & Regulations
I have made my minor aware of the rules and regulations regarding access to the amenities and understand they will be held responsible for any violations, which may result in the loss of amenity access for the entire household. Entire list of rules can be found on our website at www.heartlandtx.net.*
Yes
Heartland Youth Photo ID Card
I understand that in order to access the Heartland amenities, any minors aged 14-17 are required to have a Heartland Youth Photo ID card along with the mobile access credentials. The Youth Photo ID Cards form can be found at www.heartlandtx.net and must be submitted prior to approval for mobile credentials. *
Yes
Minor'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*
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*
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 Date of Birth*
Date of Birth
Contact Information
Minor's email address (this will be used to send credential invitation and must be different than the parent or guardian's email). *
Minor's cell phone number (this will only be used if the minor's email address does not allow credentials to be sent and should be different than the number provided in parent or guardian information). *
Cell phone service provider*
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.


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