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Wavier for the Bryce Canyon City Fitness Center

WAIVER, RELEASE AND ASSUMPTION OF THE RISK

In consideration of the use of property, facilities and/or services of the

Bryce Canyon City Recreation Center, the undersigned agrees as follows:

1. I hereby acknowledge and understand that my participation, or the participation of my minor child(ren) whose names appear below, in the City’s Recreation Center or in recreational activities sponsored by Bryce Canyon City may involve bodily and/or emotional injury and death to me and/or my child(ren). In consideration of me or my child(ren) being able to participate in such events, I, for myself, my child(ren), my heirs, assigns, executors and administrators, hereby assume all risk of such injury or death, and do hereby voluntarily and knowingly indemnify, hold harmless, defend, release, waive and discharge the Bryce Canyon City, its officers, employees, and any volunteers or owner of property where such event or activity is held, from any and all suits, claims or liability, including negligence, based on any injury except that caused solely by the willful misconduct of the Bryce Canyon City that may result from me or my child(ren)’s use of the City’s Recreation Center or participation in activities or events sponsored by the Bryce Canyon City Recreation Department. In addition, I agree that I or my insurance company shall be responsible and liable to pay for all medical and emergency services expenses or other expenses resulting from my or my child(ren)’s participation in such events or activities.

2. The undersigned understands that this is a public facility that is only periodically cleaned. There is an inherent risk that where ever the public is allowed there is the risk of exposure to contagious deceases such as COVID-19. The undersigned agrees for myself, my child(ren), my heirs, assigns, executors and administrators, that I hereby assume all risk of exposure and infection, and do hereby voluntarily and knowingly indemnify, hold harmless, defend, release, waive and discharge the Bryce Canyon City, its officers, employees, and any volunteers or owner of property where such event or activity is held, from any and all suits, claims or liability, including negligence, based on any exposure or infection that may result from me or my child(ren)’s use of the City’s Recreation Center or participation in activities or events sponsored by the Bryce Canyon City Recreation Department. In addition, I agree that I or my insurance company shall be responsible and liable to pay for all medical and emergency services expenses or other expenses resulting from my or my child(ren)’s participation in such events or activities.

3. The undersigned agrees that, prior to his/her or his/her minor child(ren)’s participation in any such event or activity, he/she shall be responsible to inspect the facilities and/or equipment to be used, and that any participation in such event or activity shall constitute his/her acceptance of such facilities and/or equipment in an “as is” condition. The undersigned further agrees that if he/she believes that at any time an unsafe condition exists, he/she will immediately advise their coach or supervisor of such condition(s) and thereafter refuse to participate.

4. I hereby authorize and give my consent to the staff/coaches of Bryce Canyon City to act in my behalf as an individual, parent or guardian in accordance with their best judgment in the case of an emergency, including the authorization of emergency medical treatment or first aid for me or my minor child(ren), if I am not present or am otherwise unable to do so. In such event, I agree to assume full responsibility for all expenses, medical or otherwise, that may arise therefrom. I understand that my insurance company or I will pay for such emergency treatment.

5. I hereby certify that I am the parent, guardian or legal custodian of the minor child(ren) whose names, addresses and ages appear below.

6. By signing this Acknowledgment, Waiver and Release of Liability, I acknowledge and represent that I have read and understand its contents and disclosures, and that I agree to all terms and conditions stated herein.

7. I grant to Bryce Canyon City, the right to take photographs of me and my family in connection with the above-identified event. I authorize Bryce Canyon City, its assigns and transferees to copyright, use and publish the same in print and/or electronically.

8. I agree that Bryce Canyon City may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

9. I understand and agree that the use of the weight room is generally for adults and mature teenagers, as such I agree that no child under the age of 12 will be allowed by me in the weight room and that children 12 and 13 years of age will be under the supervision of a parent who is on site at the time of the use.

10. I understand and agree that if I or my minor child violates any of this agreement or the posted rules of conduct in the weight room or other areas of the facility; or if I or my minor child through intent or negligence damages the facility or any property in the facility, that I will be subject to pay to Bryce Canyon City a fine of for each incident of misconduct or in the case of damage the actual cost of repair.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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