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HEARTLAND COMMUNITY ASSOCIATION, INC.

WAIVER AND RELEASE


In an effort to promote a safe environment for all owners, residents, and guests, and to minimize risk to the Heartland Community Association, Inc. (the “Community Association”), Community Association Management, the Association’s management company (“CCMC”), requests your support and cooperation by reading and signing the following Waiver and Release.

I voluntary choose to use any or all of the facilities and participate in programs offered by the Community Association, including, but not limited to, fitness areas, swimming pools, clubhouse (collectively, the “Facilities”), and participate in activities and events sponsored from time to time by the Community Association (collectively, the “Events”). In consideration for being allowed to use the Facilities and participate in the Events (collectively, the “Amenities”), I declare as follows: 

1)   I understand that each individual (including myself) has a different capacity for participating in and using the Amenities. I assume full responsibility during and after my participation for my choices to use or apply, at my own risk, any portion of the information or instruction I receive. I have read and agree to comply with the written rules and regulations for use of the Amenities.

2)   I understand that part of the risk involved in undertaking any activity or program is contingent on my own state of fitness or health (physical, mental or emotional) and to the awareness, care and skill with which I conduct myself in that activity or program. I acknowledge that my choice to participate in any activity or programs offered or made available by the Community Association brings with it my assumption of those risks or results stemming from this choice, and the fitness, health, awareness, care and skill that I possess and use. I represent to the Community Association that I am physically sound and suffering from no condition, impairment, disease, infirmity or other illness that would prevent my participation in any of the Amenities, including the use of equipment or machinery.

3)   I understand that participating in or use of the Amenities may involve risks, including economic loss, health, disabilities or death, and I willfully and voluntarily assume those risks. I will only use equipment that I know how to operate and use safely. I will not undertake any activity for which I do not feel sufficiently prepared or able. I will take all reasonable precautions to avoid injury to myself and to others and damage to property.

4)   I accept personal responsibility always to act in a safe manner and to abide by the rules and regulations of the Community Association. I agree to stop participating in any activity if I observe any unsafe conditions or broken equipment, or if I experience any pain, discomfort and/or other symptoms that I may suffer during or after participating in the activities. I understand that I may stop or delay my participation in any activity or program if I so desire and that I may also be requested to stop and rest by an employee or agent of the Community Association who observes any symptoms of distress or abnormal response, and I agree to comply with such directions.

By signing this Waiver and Release, I confirm that I have voluntarily chosen to use and participate in the Amenities. I assume all risks to my health as a consequence thereof and, on behalf of myself, my heirs, beneficiaries, dependents and personal representatives, hereby RELEASE, HOLD HARMLESS, WAIVE, FOREVER DISCHARGE, AND COVENANT NOT TO SUE the Heartland Community Association, Inc., CCMC, UST-Heartland, LP, UST-Heartland GP, LLC, Huffines Communities, Inc., Huffines Enterprises, Inc., and Huffines Management Partners, LP, their respective directors, officers, agents, employees and contractors (collectively, the "Releasees") from any responsibilities, liabilities, damages, or claims related to my use of or participation in the Amenities, including the negligence or gross negligence of the Releasees, and further agree to INDEMNIFY AND HOLD THE RELEASEES HARMLESS from any claim asserted by or on behalf of my family members or any of my guests based on facts or circumstances involving the use of or participation in the Amenities.  

Owners and/or residents are responsible for the conduct of their guests. Owners and/or residents and their guests shall not reprimand nor discipline any employee or agent of the Community Association. Community Association employees or agents will inform owners, residents or guests of any violation of the rules and regulations of the Community Association, and, when necessary, report such actions to the Board of Directors of the Community Association.

I have read and understood the contents of this Waiver and Release and have had the opportunity to consult with an attorney of my choosing prior to placing my signature below.

PHOTO RELEASE FORM

I hereby expressly grant HEARTLAND COMMUNITY ASSOCIATION, INC. and HUFFINES COMMUNITIES, INC. and their subsidiaries and affiliated communities, and their employees, officers, representatives, licensees, agents, and assigns (all of which are referred to herein as “the Companies”), the unlimited worldwide right, permission, and license to the use of my name, physical likeness (as the same may appear in any still camera photography, videotape recording, motion picture film, electronic representation and/or sound recordings made of me), and voice in connection with the creation of video media and exhibition of said media on television, cable, satellite, internet, live event, or otherwise, without compensation or prior notice to me from the Companies. Permission is granted to use all or any part of said reproduction and to edit them as deemed necessary in the sole discretion of the Companies for print, publication, theatrical motion pictures, or from other mediums.

I hereby waive any inspection or approval of the finished advertisement, and I release the Companies from any liability for any claim of alteration, optical illusion, or faulty mechanical reproduction, and likewise with respect to any distortion or illusion in reproduction.

I hereby certify that and represent that I have the read and understood the foregoing and fully understand the meaning and effect thereof.



First Heartland Resident Name

First Name*

Last Name*

Phone*
First Heartland Resident Age Acknowledgment*
First Heartland Resident Date of Birth*
I certify that I am 18 years of age or older
First Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
First Heartland Resident Signature*
Second Heartland Resident Name

First Name*

Last Name*
Second Heartland Resident Date of Birth*
Second Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Third Heartland Resident Name

First Name*

Last Name*
Third Heartland Resident Date of Birth*
Third Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Fourth Heartland Resident Name

First Name*

Last Name*
Fourth Heartland Resident Date of Birth*
Fourth Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Fifth Heartland Resident Name

First Name*

Last Name*
Fifth Heartland Resident Date of Birth*
Fifth Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Sixth Heartland Resident Name

First Name*

Last Name*
Sixth Heartland Resident Date of Birth*
Sixth Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Seventh Heartland Resident Name

First Name*

Last Name*
Seventh Heartland Resident Date of Birth*
Seventh Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Eighth Heartland Resident Name

First Name*

Last Name*
Eighth Heartland Resident Date of Birth*
Eighth Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Ninth Heartland Resident Name

First Name*

Last Name*
Ninth Heartland Resident Date of Birth*
Ninth Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Tenth Heartland Resident Name

First Name*

Last Name*
Tenth Heartland Resident Date of Birth*
Tenth Heartland Resident Cell Phone Provider
Please select the cell phone service provider for the number above*
Heartland Resident 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
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Proof of Residency - REQUIRED FOR ALL RESIDENTS

To receive a mobile credential, all residents must provide proof of residency and a valid government-issued identification. The required documentation varies based on ownership/tenant/occupant status:

*Accounts with the Association must be current in order to receive access to amenities*

*Each household is allowed 4 complimentary credentials for amenity use. Up to 2 additional credentials are available for members of the household, up to a total of 6 credentials per household, for a fee of $20 per extra credential.* 

Homeowners

  • Must provide proof of residency by presenting a contract, title, or closing document with their name listed or a government-issued ID with your Heartland address.

Tenants (renting in Heartland)

  • Must provide proof of residency by presenting a 12 month lease with their name listed.
  • Amenity Authorization form must be completed by landlord. Amenity access will not be approved until form is submitted. Form can be found at www.heartlandtx.net -> Resident Resources -> Resident Essentials.

Adult Occupants (not listed on ownership or lease documents)

  • Must provide proof of residency by presenting a government-issued ID with a Heartland address.

Temporary Access Credentials for Adult Occupants

  • If an adult occupant does not yet have an updated ID, a 90-day temporary access credential may be issued.
  • The resident must provide proof of residency (such as a leaseholder's written confirmation and a supporting document like a utility bill).
  • If required by law, the occupant should show proof of an appointment with the Department of Public Safety to update their ID.
  • Abuse of this policy may result in deactivation of all household access credentials.

Additional Credentials (5th and 6th members of the household):

  • Additional adult users must complete the general waiver form (or minors waiver form if between 14-17 years old).
  • The additional users form, available at www.heartlandtx.net, must also be completed with payment submitted prior to approval of any additional user credentials. 

Submitting waivers for minors (14-17)

  • Please complete the minors waiver form, including all minors in your household.



UPLOAD THE APPROPRIATE DOCUMENT AS OUTLINED ABOVE HERE:

  
*
Valid file types: JPG, GIF, PNG, and PDF
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Cell Phone Provider
Please select the cell phone service provider for the number above*
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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