Gray Eagle Swim Club Guest Waiver
This form is required for anyone coming to the Gray Eagle Swim Club as a guest.
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Legal Guardian First Name *
Legal Guardian Last Name *
Please list Family Member #1 to be included on this waiver: *
Please list Family Member #2 to be included on this waiver:
Please list Family Member #3 to be included on this waiver:
Please list Family Member #4 to be included on this waiver:
Please list Family Member #5 to be included on this waiver:
Please list Family Member #6 to be included on this waiver:
I am the legal guardian to all the minor children listed on this form *
In case of emergency, WHO should be called? (First and Last name of individual to be called) *
In case of emergency, what is the phone number for the person listed above?
In case of emergency, what is relationship to the minor children listed on this form? *
In case of emergency, do you have a secondary contact name and phone number?
Gray Eagle GUEST Rock Climbing Wall Release and Waiver 2022. Everyone listed on my Family Membership with Gray Eagle Swim Club, understands and agrees to the following terms contained in this instrument (“Release”), which include that my use and/or my children’s use of a certain rock climbing wall (“Wall”) within the Gray Eagle Swim Club (“Gray Eagle”), located at 12101 Brooks School Road, Fishers, Indiana, or will expose me and/or my children to risk of injury or harm. Such risk includes, but is not limited to, injury from falling off the wall, injury from colliding against the Wall, and drowning. Parent understands and agrees that rock climbing can be hazardous and/or involve hazardous conditions and may result in injury to Parent and/or Parent’s children, particularly given that the Wall is adjacent to the Gray Eagle pool and is designed for users to move from the designated portion of the Wall directly into the Gray Eagle pool without the use or availability of a harness or other rock climbing accessories. No form of preplanning can remove all dangers to which Parent and/or Parent’s children are exposing themselves through their use of the Wall.By signing this Release, Parent represents that Parent is over eighteen (18) years of age, is fully competent, has no health or physical problems that will interfere with his/her use of the Wall, that his/her children that may use the Wall only if they pass the lifeguard administered swim test (swim from lifeguard chair to the Wall without touching the bottom at Gray Eagle) and have no health or physical problems that will interfere with their use of the Wall, and executes this Release for full, adequate, and complete consideration with full intention to be bound by this Release and for Parent’s children to be bound by this Release for the entire 2022 pool season. By signing this Release, Parent understands and agrees/represents that Parent: is fully responsible for his/her own safety and the safety of Parent’s children while using the Wall, regardless of the presence of lifeguard(s);is fully responsible for becoming familiar with any and all rules and regulations concerning the use of the Wall and shall not violate any of said rules and regulations, in addition to any instruction made be or Gray Eagle personnel with respect to the use of the Wallor the Gray Eagle pool; has been advised to obtain adequate health and accident insurance to cover any personal injury to Parent or Parent’s children, which may be sustained during the use of the Wall; fully assumes all risks associated with Parent’s or Parent’s children’s use of the Wall; is fully responsible for any loss, damage, or injury which may occur to Parent or Parent’s children, as a result of Parent’s or Parent’s children’s use of the Wall; in consideration for using the Wall, hereby releases, waives, discharges, and covenants not to sue Gray Eagle HOA, Inc., its principals, agents, representatives, affiliates, managers, officers, members, directors, employees, lifeguards, other volunteers, and successors and assigns(collectively “Releasees”) for/from any liability, claims, demands, actions and I have received a copy of the Pool Rules and Rock Wall Waiver causes of action whatsoever arising out of or related to any loss, costs, damage, or injury that may be sustained by Parent or Parent’s children, whether caused by Releasees’ negligence or otherwise; and has had the opportunity to inspect the Wall prior to using the Wall and/or prior to Parent’s children using the Wall; *
Required
COVID-19 Liability Release Waiver. The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions Gray Eagle Swim Club adheres to comply. In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following: I am aware of the existence of the risk on my physical appearance to Gray Eagle Swim Club and my participation may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19 that may lead to I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days or death. My family will not come to the pool if we have experienced symptoms of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 14 days. I have not, nor any member(s) of my household, traveled by sea or by air, internationally within the past 30 days. I did not, nor any member of my household, visit any area within the United States that was reported to be highly affected by COVID-19, in the last 30 days. Following the pronouncements above I hereby declare the following: I am fully and personally responsible for my own safety and that of all family members listed on my Membership Form and my guests and actions while and during may participation and I recognize that I maybe in any case be at risk of contracting COVID-19.With full knowledge of the risks involved, I hereby release, waive, discharge the Gray Eagle HOA, Inc., its employees, independent contractors, affiliates, representatives, volunteers, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.Iagree to indemnify, defend, and hold harmless Gray Eagle Swim Club from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19. *
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