Loading...

CARLTON FOOTBALL CLUB – GYM AQUATIC FACILITY WAIVER

WAIVER AND RELEASE

This is a legal document that affects my rights. I acknowledge that my use of this gymnasium and/or aquatic facility involves a significant degree of physical exertion and a degree of physical risk. I am using this gymnasium and/or aquatic facility for the purpose of prescribed or voluntary training, or rehab, or recovery, or recreation, or enjoyment, or leisure. I am informed and I acknowledge that use of a gymnasium and/or aquatic facility and the activities associated with the use of a gymnasium and /or aquatic facility is an inherently risky activity involving unpredictable and unforeseeable risks of harm. This harm includes death or personal injury.

I willingly assume the risk of participating in the exercises, training program, and all other activities of this gym and/or aquatic facility. I have provided Carlton Football Club with all relevant and necessary information that relates to my physical health and capacity to participate in strenuous exercise. I understand that if Carlton Football Club were not provided with all relevant and necessary information about my health and capacity they would not be able to fully appreciate the risk of harm or injury to me in providing instruction and in allowing me to participate in this activity. I (or my parent or guardian) willingly provides the following waiver:

(a) I do not hold Carlton Football Club or their employees or agents legally responsible for injuries I suffer on their premises or using their equipment or participating in their training or activities programs.

(b) I undertake not to sue Carlton Football Club or their employees or agents for any claims, costs, damages, or other liabilities they may have for injury suffered by me and I acknowledge that this waiver represents a legal release and discharge of legal responsibility to Carlton Football Club or their servants or agents. It is provided in exchange for the goods and services purchased by me.

(c) I have been informed and I accept that I may also be assuming a role involving responsibility for the safety of others participating in the activities of this Gym and/or Aquatic Facility. This means I will accept responsibility for the safety of another person and if an injury occurs as a result of my careless act, omission or negligence then I fully assume responsibility for any harm done and I do not hold Carlton Football Club concurrently responsible. I warrant not to use the gym while intoxicated or affected by drugs.

(d) My medical conditions are stable or I have no significant medical conditions limiting aquatic exercise. I have no infectious diseases. I will only exercise to a moderate intensity and I will rehydrate after being in the pool. I have read the Aquatic Facility rules and will adhere to them.

First Player Name

First Name*

Last Name*

Phone*
First Player Date of Birth*
First Player Signature*
Second Player Name

First Name*

Last Name*
Second Player Date of Birth*
Third Player Name

First Name*

Last Name*
Third Player Date of Birth*
Fourth Player Name

First Name*

Last Name*
Fourth Player Date of Birth*
Fifth Player Name

First Name*

Last Name*
Fifth Player Date of Birth*
Sixth Player Name

First Name*

Last Name*
Sixth Player Date of Birth*
Seventh Player Name

First Name*

Last Name*
Seventh Player Date of Birth*
Eighth Player Name

First Name*

Last Name*
Eighth Player Date of Birth*
Ninth Player Name

First Name*

Last Name*
Ninth Player Date of Birth*
Tenth Player Name

First Name*

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

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
Insurance

Insurance Carrier*

Insurance Policy 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*

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!