Loading...

PLEASE READ CAREFULLY.  THIS IS A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS.

I understand and agree that each person (a “Participant”) engaging in any of events, programs, classes, and/or other activities (together, the “Activity” or “Activities”) of the Snyderville Basin Special Recreation District’s ("Basin Recreation") and/or using any structures, facilities, parks, trails, playgrounds, playfields, and/or equipment (together, the “Facility” or “Facilities”) of Basin Recreation, shall be legally bound by this Release of Liability and Waiver (this “Release”). I am signing this Release on my own behalf and, if a Participant is under the age of 18, I am signing as the minor Participant’s parent or legal guardian.

I agree that prior to participating, I will inspect the Facilities to be used and, if I believe to the best of my ability that anything is unsafe, I will immediately advise Basin Recreation of such condition(s) and refuse to participate.

I acknowledge that there are foreseeable and unforeseeable risks and other hazards inherent in the Activity, which may expose the Participant to illness, injury or death, and I hereby certify that I freely and voluntarily participate or allow participation in the Activity with the knowledge of the danger involved, including, without limitation, the hazards of bodily injury associated with any Facility. I assume all the foregoing risks and accept personal legal and financial responsibility for the damages following such injury, permanent disability or death.

I acknowledge that Basin Recreation is not an insurer of behavior, actions, or participation in the Activity, and that Basin Recreation assumes no liability whatsoever for personal injuries or property damages to Participants or to third parties arising out of participation in the Activity. I agree to release, waive, covenant not to sue, indemnify and hold harmless Basin Recreation, and all of Basin Recreation’s officers, employees and agents (collectively the “Releasees”) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by Participant or loss or damage to any property belonging to Participant arising out of or related to participation in the Activity or use of any Facility, excepting only such loss, damage, or injury as may be caused by the sole gross negligence of any Releasee.

I warrant that Participant does not have any medical conditions that would prevent participation in the Activity or which create unacceptable risk of harm to Participant or to others.

Use of the Facilities and participation in the Activities may necessitate the use of shared Facilities, such as restrooms and/or equipment, and thus includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While adherence to rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation. I acknowledge and agree to the prohibition on participation in any Activity or use of any Facility while symptomatic of an infectious disease.

I understand that concussions and head injuries are risks associated with the Activity and agree to abide by a Basin Recreation official’s decision to remove the Participant from an Activity if the official suspects the Participant has sustained a head injury or concussion. I also agree prior to resuming participation in the Activity that the Participant shall be evaluated by a “Qualified Heath Care Professional, who is defined as (a) a medical professional trained in the evaluation and management of concussions, and (b) who has successfully completed a continuing education course in the evaluation and management of concussions within the three (3) years immediately preceding the medical evaluation of Participant. Participant shall provide to Basin Recreation a written statement signed by a Qualified Health Care Professional clearing the Participant to resume participation in the Activity.

I understand and agree to observe posted age limitations in or on Facilities.

I understand and agree to observe the age limitation of fourteen (14) years of age or older for all Activities unless such Activities are specifically designated for those younger than fourteen (14) years of age.

I understand that I retain complete responsibility for the supervision and safety of any minor children that are in my care and custody while such children are in or on Basin Recreation Facilities, whether such children are participating in an Activity or simply in attendance.

I agree that the venue of any lawsuit arising out of or related to participation in an Activity shall be in the Third District Court in and for Summit County, Utah and that this Release will be governed by and construed in accordance with the laws of the State of Utah, without application of any principles of choice of law. I agree to pay any attorneys’ fees or costs incurred by Basin Recreation in enforcing this Release.

I authorize and give my full consent to Basin Recreation to copyright and/or publish all photographs, videotapes and/or film in which the Participant appears while participating in the Activity. I further agree that Basin Recreation may transfer, use or cause to be used, these photographs, videotapes or films for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations.

If I am a coach, I acknowledge and consent to my contact information (phone number and email) being made public in the publishing of schedules and/or team rosters. As a Participant, I acknowledge and consent to my contact information (phone number and email) being provided to coach(es).

I understand and agree that Basin Recreation’s Facilities and Activities are public and the Participant’s behavior impacts other patrons. Should the Participant behave in a manner that Basin Recreation management deems inappropriate, including but not limited to behavior that is threatening, dangerous, offensive, unsportsmanlike or obscene, I understand that any recreation pass or other indicia of authorization to use Basin Recreation Facilities may be revoked or suspended, and/or participation in any Activity may be prohibited.

In the case of emergency, I give my permission for emergency medical treatment for Participant.

I HAVE READ THE ABOVE AGREEMENT, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE NOT CHANGED IT ORALLY.

 

Please select who will be participating...
AdultMinor
Continue
First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
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*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Which user group(s) does this waiver apply to?
Select all that apply *
Fieldhouse Memberships & Fitness Activities
School Group
Baseball
Basketball
Lacrosse
Pickelball
Volleyball
Football
Soccer
Facility Rental
Volunteers
Birthday Party
Bounce House & Inflatables
Special Event
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 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!