PLEASE READ CAREFULLY: BY SIGNING THIS DOCUMENT, YOU ARE WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING ANY INJURY. *

I Agree

PARTICIPANT NAME *

First Name

Last Name

PARTICIPANT DATE OF BIRTH *

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PARENT OR LEGAL GUARDIAN NAMEINCLUDING PARTICIPATING PARENTS (if participant is under 18),

First Name

Last Name

PARTIES PROTECTED BY THIS WAIVER: North Island Aquatic Club, its officers, directors, employees, coaches, agents, volunteers, and pool facility providers. *

I agree

ACKNOWLEDGEMENT AND ASSUMPTION OF RISK: I acknowledge that participating in the activities offered by North Island Aquatic Club, including but not limited to swimming instruction, swimming, lifesaving skills, open-water rescue techniques, CPR, physical conditioning, mock rescue scenarios, and beach-based activities such as running, strength exercises, and aquatic safety games, carry inherent risks, dangers, and hazards. These may arise directly or indirectly from my participation in the activities, including but not limited to negligence of other participants and NEGLIGENCE ON THE PART OF THE RELEASEES. I acknowledge that these risks may result in personal injury, death, property damage, or loss. *

I FULLY AND FREELY ACCEPT AND ASSUME ALL RISKS, DANGERS, AND HAZARDS, INCLUDING THE POSSIBILITY OF SERIOUS INJURY OR DEATH.

WAIVER AND RELEASE OF LIABILITY: In consideration of being permitted to participate in the activities provided by North Island Aquatic Club, I hereby agree TO WAIVE AND RELEASE ANY AND ALL CLAIMS that I, my family members, or anyone claiming through me may have against the RELEASEES for any loss, damage, injury, or death due to any cause whatsoever, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF STATUTORY DUTY by the RELEASEES. *

I AGREE

INDEMNITY: I agree to indemnify and hold harmless the RELEASEES from any claims, expenses, legal fees, or other costs arising from any claim brought by me or on my behalf due to my participation in North Island Aquatic Club programs. *

I understand and agree that this waiver is binding, and any unenforceable term will not affect the enforceability of the remaining terms.

Today's Date *

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