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Pearl Lake Beach Beach/Activities Waiver

PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK

In consideration of being allowed to use the facilities and participate in activities provided by Pearl Lake Beach LLC, I hereby agree to release, indemnify, and discharge Pearl Lake Beach LLC, their agents, owners, officers, volunteers, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "PLB"), on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:

1.I acknowledge that my/ or my minors participation in swimming, kayak, paddleboards, personal watercraft, inflatable obstacle course (WIBIT) and other water activities  (collectively, the "Activities") is at my/ or my minors own risk and entails inherent risks involved with the Activities, including, but not limited to, bruises, scrapes, lacerations, burns, sprains, fractured or broken bones, as well as other head/brain, face, neck, back/spine injuries, including drowning and death and/or actual or alleged contracting of any communicable bacterial or viral based diseases.

2. I expressly agree and promise to accept and assume all of the risks existing in the Activities. My/ or my minors participation in this activity is purely voluntary, and I/ or my minors elect to participate despite the risks. Additionally, I/ or my minors agree to wear a personal flotation device (life jacket) while participating in kayak, paddleboard, personal watercraft activities or on the WIBIT. In addition, I agree that my minors if under 8 years old will wear a life jacket at all times while swimming at PLB. I also acknowledge that there are NO lifeguards on duty at PLB and I am solely responsible for the supervision of my minors. Initialing this are does not negate my responsibility to read, understand and abide by the balance of this waiver.


3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless PLB from any and all claims, demands, or causes of action, which are in any way connected with my/ or my minors participation in the Activities or my use of PLB 's equipment or facilities, including any such claims which allege negligent acts or omissions of PLB.

4. Should PLB or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.

6. This Indemnification and Release shall be governed by the laws of the State of Illinois. I agree that any Claims I may bring against PLB shall be submitted to the jurisdiction of the courts of Winnebago County, Illinois and that no Claims against PLB shall be brought in any other jurisdiction. I also agree that if any part of this Indemnification and Release is deemed unenforceable, all remaining parts shall remain in full force and effect. I agree that PLB has made no warranties, expressed, or implied, to me beyond those, if any, contained in this Indemnification and Release.

In addition, I acknowledge that once I have entered the premises, no refunds will be made for PLB or the Activities. Furthermore, I agree that failure to abide by posted PLB rules may result in revoked privileges to participate and/or removal from PLB. I also waive and release any claims I may have related to the use of recorded media of me/ or my minors at PLB including, without limitation, any right to approve any photos, videos or audio recordings of me/ or my minors, any claims of privacy, violation of the right of publicity, defamation, copyright infringement and/or collection of any compensation (fees) for use of such recorded media.

I further agree that I am personally liable and responsible for paying PLB for any and all damage to PLB property that I/ or my minors may cause, whether caused negligently, recklessly or intentionally, while using or participating in the Activities, including, but not limited to, damage to any PLB equipment or other PLB, any loss of PLB equipment or loss of use of equipment, any claims for diminution in value of any PLB equipment, and/or the cost of repair or replacing any PLB equipment. I authorize PLB, at PLB’s discretion, to bill any such charges or costs directly to my credit card or to my account without further notice to me.

(If applicable) I hereby represent and warrant that I am the parent/legal guardian of the minors I sign for. I further represent and warrant that I am at least eighteen (18) years of age. I/my Minors is in good physical and mental health and does not suffer from any mental condition, physical condition, disability, sickness, disease, or infection that may render our participation in any of the Activities hazardous to ourselves or to others or that may impair our ability to participate in the activity. In the event of an emergency, I hereby represent that I have authority to give, and hereby give consent for my minors to receive medical treatment that may be deemed advisable in the event of injury, accident, and/or illness during the activities.

I further acknowledge that PLB personnel have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction. I

agree that none of the Released Parties has any obligation or responsibility to evaluate my/my Minors mental condition, physical condition, disability, sickness, disease, infection, or any limitations associated with my/my minors participation in the activities.

By signing this document, I acknowledge that if I/ or my minors are hurt or property is damaged during my/ or my minors participation in the Activities, I may be found by a court of law to have waived my right to maintain a lawsuit against PLB on the basis of any claim from which I have released them herein. I also agree that this document is valid for subsequent visits and participation at PLB. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
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*
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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*
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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