Loading...

SquashRx New Canaan Insurance Waiver and Release of Liability


In consideration of being allowed to participate in any way in SquashRx New Canaan ("SquashRx"), and in its programs and activities, I and/or the minor participant, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, the undersigned hereby understand and agree to the following:

Identification of Risk:​ I understand that there are inherent and other risks involved in sport, that injuries are a common and ordinary occurrence, and that the sport of squash involves risks of serious injury, including permanent disability and death. I understand that these injuries might result not only from my actions, but the actions, inactions, or negligence of others.

Assumption of Risk:​  I agree that I am responsible for my safety while participating in the activities and using the facilities and equipment associated with SquashRx, and that such responsibility includes being physically and psychologically prepared to participate, familiarizing myself with the venue before beginning, and using equipment safely. I acknowledge that SquashRx ​does not provide staffing, supervision, instruction, or assistance for the use of the facilities and equipment. ​I assume all risks, both known and unknown, connected with my participation.

Waiver:​ Being aware of the risks and willing to assume them, I hereby release from any legal liability SquashRx LLC, St. Luke’s School, St. Luke’s Foundation, St Luke’s Squash Club LLC, its owners, agents, directors, officers, coaches, employees, sponsors, owners/lessors of property and courts as well as the owners, manufacturers and distributors of equipment provided to me from liability for injury or death to myself or to any other person or damage to property resulting from my participation in the squash program and for any claim based upon negligence, breach of warranty, contract or other legal theory, accepting myself the full responsibility for any such injury, death or damage which may result. I intend for this waiver and release to apply to my relatives, personal representative, heirs, beneficiaries, next of kin, and assigns. This agreement is governed by the applicable law of the State of Connecticut. If any part of this agreement is determined to be unenforceable, all other parts shall be given full force effect. This waiver does not release acts of gross negligence or willful and wanton misconduct of any party.

Insurance:​ I currently have and agree to maintain throughout the time I participate, sufficient liability, medical and accident insurance. I understand that this is my responsibility and release anyone else from providing it for me.

I have read this agreement carefully, I understand that I give up substantial rights by signing it, and I sign it voluntarily.

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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*
Check to receive information, news, and discounts by e-mail.
FOR PARTICIPANTS OF MINORITY AGE:​ This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent to the above person’s participation in the St. Luke’s Squash Club program. I acknowledge, for myself and the above person, that we assume all risks, known and unknown, and waive all claims in advance. I have read this agreement carefully, understand that the above person and I give up substantial rights by signing it, and sign it voluntarily.


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 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!