Loading...

WAIVER, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT 

TODAY'S DATE: November 18, 2024

WAIVER: In consideration of permission to use, today and all future dates, the property, facility, staff, equipment and services of the Park City Municipal Corporation, the Park City Ice Arena, and the Park City Ice Arena Equipment Rental Facility, collectively referred to as “the City”, I, for myself, my heirs, personal representatives or assigns or, for my child, their heirs, personal representatives or assigns do hereby waive, release, and discharge the City, its employees, officers, and agents, from and against any and all claims, including, but not limited to, those arising from the negligence of the City, my or my child’s participation in, or observation of, the City’s recreation programs or activities, and use of facilities, premises or equipment, resulting in illness, injury, death, or property loss.

ASSUMPTION OF RISK: I understand that physical activity, by its very nature, carries with it inherent risks that cannot be eliminated regardless of care taken to avoid injuries. I recognize that engaging in, as well as, observing this recreational event or activity, and using rental equipment or personal equipment for ice skating and other sports can involve risk of personal injury or death. I hereby assert that my or my child’s participation is voluntary and I knowingly assume such risks for myself or my child. I also understand that I, my child, our heirs, personal representatives and assigns are barred by Utah Code Section 78B-4-509 from bringing any claims against the City for injuries or damages resulting from the inherent risks of participating in this recreational activity.

CONCUSSION AND HEAD INJURY POLICY. The City’s Concussion and Head Injury Policy can be found here. Concussions and head injuries can be caused by bumps or blows to the head and pose a serious risk to participants of all recreational sporting events. They can range from mild to severe and can disrupt the way the brain normally works. All are potentially serious and may result in complications, including prolonged brain damage and death if not recognized and managed properly. Continuing to play with the signs and symptoms of a concussion and/or traumatic head injury leaves individuals vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the individual suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. Additionally, having had one concussion significantly increases a person’s risk of having another. Symptoms of a concussion may include the following: (1) Headache or “pressure” in head, (2) Nausea or vomiting, (3) Balance problems or dizziness, (4) Double or blurry vision, (5) Bothered by light, (6) Bothered by noise, (7) Feeling sluggish, hazy, foggy, or groggy, (8) Difficulty paying attention, (9) Memory problems, (10) Transient confusion, disorientation, or impaired consciousness, and (11) Loss of consciousness. By signing below, I acknowledge that I have read, understand, and agree to abide by, the Concussion and Head Injury Policy. I understand that concussions and head injuries are risks associated with any sporting event. I agree that I will abide by a City official’s decision to remove myself or my child from a sporting event if the official suspects me or my child has sustained a head injury or concussion. I also agree to abide by the policy’s mandate to provide a note from a qualified health professional before my child may resume participation in Department sporting events.

INDEMNIFICATION AND HOLD HARMLESS: I agree, on behalf of myself and my child to INDEMNIFY and HOLD HARMLESS the City, its employees, officers, and agents, from any and all claims, actions, suits, procedures, costs, damages and liabilities, including attorneys’ fees, brought as a result of my or my child’s involvement at the City’s facilities and to reimburse them for any such expenses incurred.

SEVERABILITY: The undersigned expressly agrees that the foregoing Waiver, Assumption of Risk and Indemnity Agreement is intended to be as broad and inclusive as permitted by the State of Utah, and that if any portion thereof is held invalid, it is agreed that the balance shall continue in full legal force and effect.

ACKNOWLEDGEMENT AND UNDERSTANDING: I have read this Waiver, Assumption of Risk and Indemnity Agreement, fully understand its terms and agree that I am giving up substantial rights, including my and my child’s right to sue. I acknowledge that I am signing this agreement freely and voluntarily, and I intend my signature to be a complete and unconditional release of liability to the greatest extent allowed by law.

CONSENT TO BE PHOTOGRAPHED: I agree that any photographs/video taken of me or my child during the recreation program may be used in future promotional materials. I further agree that this Waiver SHALL BE EFFECT NOW AND EACH TIME I or my child uses this facility thereafter.

NOTICE TO THE MINOR CHILD’S GUARDIAN: READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE CITY USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT, YOUR RIGHT, AND THE RIGHTS OF OTHERS TO RECOVER FROM THE CITY IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE AN INHERENT PART OF THE ACTIVITY.

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Zip Code:
I have residence in:*
NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE CITY USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. YOU AND YOUR CHILD ARE BARRED BY UTAH CODE SECTION 78B-4-509 FROM BRINGING ANY CLAIMS AGAINST THE CITY FOR ANY INJURIES OR DAMAGES RESULTING FROM THE INHERENT RISKS OF PARTICIPATING IN THIS RECREATIONAL ACTIVITY. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT, YOUR RIGHT, AND THE RIGHTS OF OTHERS TO RECOVER FROM THE CITY IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM. THE CITY HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. I am the parent or legal guardian of, who is a minor child under the age of 18. I have the legal authority to execute a waiver on behalf this minor child. I agree to waive and release Park City Municipal Corporation, Park City Ice Arena, and Park City Ice Arena Equipment Rental Facility, collectively referred to as "the City", including its employees, officers, and agents, from and against any and all claims of negligence, including cost liabilities, expenses, or judgments, as well as costs and damages relating to any resulting illness or injury, arising from my child's participation in the City's recreation programs. I hereby agree to indemnify and hold harmless the City from and against any and all such claims. I understand and agree that by signing this waiver I am freeing the City, its employees, officers, and agents from any liability that may result from my child's participation in the sponsored event or activity. I recognize that this recreational event or activity can be dangerous to my child. I am also aware that the use of rental equipment or personal equipment for ice skating and other sports can involve risk of personal injury or death. I accept and assume the dangers and risks involved in this activity. I understand that claims against the City for injuries or damages resulting from the inherent risks of participating in this recreational activity are barred by Utah Code Section 78B-4-509. I furthermore agree to waive and release the City, its employees, officers, and agents, from any liability or claim of negligence for damage or injury to my child, or to any person or property resulting from the use of rental equipment or personal equipment. I accept for use "as is" any equipment rented from or loaned by the City and accept full responsibility for the care of the equipment while it is in my or my child's possession. I understand that if my child is injured, this Waiver will be used against me, my child and anyone else claiming damages because of my child's injury in any legal action. I also understand that no employee or agent is authorized to modify this Waiver. I recognize that if any provision of this Waiver is determined to be unenforceable for any reason, all other provisions shall be given full force and effect. I hereby represent that I understand and am familiar with the nature of the activities in which my child will participate, that my child is in good health, and that my child does not have a physical or emotional condition, past or present, of which I am aware, which would in any way affect my child's ability to participate in the event or activity. I also agree that any photographs/video taken of my child during the recreation program may be used in future promotional materials. I further agree that this Waiver has been and shall be construed as having been made and delivered within the state of Utah and this Waiver shall be governed by laws of the state of Utah, both as to interpretation and performance. Any action of law, suit in equity, or judicial proceeding arising from or relating to this Waiver, or any provisions thereof, shall be instituted and maintained only in any of the courts of competent jurisdiction in Summit County, Utah. I further agree that this Waiver shall be in effect now and each time my child uses this facility thereafter. I consent to the use of the jump harness in teaching of my child's ice skating. I understand that: a belt will be attached to the waist of my skater in order to enable a skating instructor to lift the skater three to five feet (3'-5') off the ice surface or floor; that the skater is pulled along and then lifted during the jump; and , that the rope and pulley, which are part of the apparatus, are attached to a wire that is stretched over the ice surface or floor.


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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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!