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Each of the undersigned in consideration for participation at the Maca Aquatic Center and all city properties, on behalf of myself and/or any minor child included herein, and my/his/her heirs, executors, administrators, and assigns, do hereby release and forever hold harmless the City of Tallmadge, its officers, employees, agents and assigns from any and all liability, claims, costs, expenses, injuries suits, damages and/or losses, that may be sustained as a result of participation in the listed activity. I understand that physical exercise, sports, and similar, related, and associated activities involve physical exertion, contact with others, use of equipment, and associated conduct. I understand that with voluntary participation, I/he/she/we are exposed to risk of personal injury, communicable disease, and/or death and property damage or loss from use of the facility and equipment therein. In consideration for the opportunity to participate, I voluntarily assume all risks involved in my/his/her/their participation and travel to and/or from the Maca Aquatic Center on behalf of myself and any minor child included herein, and my/his/her/our heirs, executors, administrators, and assigns. I grant and permit the use of images of myself, and any minor child included herein by the City of Tallmadge for newspaper advertising, grant proposals, official websites, and other public uses. I may rescind this permission at any time by giving notice to the City of Tallmadge. No compensation will be given for the use of said images. I have carefully read this document, understand its contents, and am fully informed about the activities at the Maca Aquatic Center and am satisfied for myself and any minor children of mine included in this activity that each of us can safely participate in the activities provided at the facility. 

I understand that this document affects important legal rights. I sign freely and voluntarily. NO REFUNDS ARE GIVEN FOR WALK-IN PASSES

First Participant's Name
First Name*
Last Name*
Phone*
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First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
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Emergency Contact
First Name*
Last 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.


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