ATTN PARENTS: Please consider donating time and/or money to help make this event a success!  We can't do this without your support!

Visit www.centaurussnap.org to help.

IN CONSIDERATION for being permitted to utilize the facilities, services, and programs of the YMCA of
Northern Colorado (the “YMCA”) and/or for my children listed above to so participate for any purpose,
including, but not limited to observation or use of facilities or equipment, or participation in any off-site
program affiliated with the YMCA, the undersigned, on behalf of himself or herself and such participating
children and any personal representatives, heirs, and next of kin (hereinafter referred to as “the undersigned”)
hereby acknowledges, agrees and represents that he or she has inspected and carefully considered such premises, equipment and facilities and/or the affiliated program and that the undersigned finds and accepts same as being safe and reasonably suited for the use or participation by the undersigned and such participating children.

In addition, the undersigned acknowledges that novel coronavirus (“COVID-19”) infections have been
confirmed throughout the United States and Colorado, including cases in the counties in which the YMCA
operates. In accordance with the most recent guidance and protocols issued by the World Health Organization
(WHO), the Centers for Disease Control and Prevention (CDC), the Colorado Department of Public Health
(CDPH), the county health departments in the counties in which the YMCA operates (together, the “Public
Health Agencies”) for slowing the transmission of COVID-19, the undersigned hereby agrees, represents, and
warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services,
and programs of the YMCA (other than any exclusively online services and programs) within 14 days after (i)
returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice, (ii) exposure to any person
returning from areas subject to a CDC Level 3 Travel Health Notice, (iii) exposure to any person who has a
suspected or confirmed case of COVID-19, or (iv) beginning quarantine due to exposure to any person who has
a suspected or confirmed case of COVID-19.

The undersigned agrees to check the CDC Travel Health Notices list (https://www.cdc.gov/coronavirus/2019-
ncov/travelers/index.html) prior to utilizing the facilities, services, and programs of the YMCA, on a daily basis
if necessary. The undersigned hereby agrees, represents, and warrants that neither the undersigned nor such
participating children shall visit or utilize the facilities, services, and programs of the YMCA if he or she (i)
experiences symptoms of COVID-19, including, without limitation, fever, fatigue, cough or shortness of breath,
(ii) has a suspected or diagnosed/confirmed case of COVID-19, or (iii) knows or should know he or she is subject
to quarantine, or is required to quarantine, due to exposure to any person who has a suspected or confirmed case of COVID-19. The undersigned agrees to notify the YMCA immediately if he or she believes that any of the
foregoing access/use restrictions may apply.

The YMCA has taken certain steps to implement recommended guidance and protocols issued by the Public
Health Agencies for slowing the transmission of COVID-19, including, without limitation, the access/use
restrictions set forth above. The undersigned acknowledges and agrees that the YMCA may revise its procedures at any time based on updated recommended guidance and protocols issued by the Public Health Agencies and further agrees to comply with the YMCA’s revised procedures prior to utilizing the facilities, services, and programs of the YMCA. The undersigned fully understands and appreciates both the known and potential dangers of utilizing the facilities, services, and programs of the YMCA and acknowledges that use thereof by the undersigned and/or such participating children may, despite the YMCA’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death.

IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE
INCLUDING, BUT NOT LIMITED TO, OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR
PARTICIPATION IN ANY ON-SITE OR OFF-SITE PROGRAM AFFILIATED WITH THE YMCA, THE
UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:

THE UNDERSIGNED, ON HIS OR HER BEHALF AND ON BEHALF OF SUCH PARTICIPATING
CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the
YMCA, its directors, officers, employees, volunteers, representatives, agents, successors and assigns,
administrators, and executors (hereinafter referred to as “Releasees”) from all liability to the undersigned or
such participating children and all personal representatives, assigns, heirs, and next of kin of the undersigned or
such participating children for any loss or damage, and any claim or demands on account of any property damage or any injury to, or an illness or the death of, the undersigned or such participating children (or any person who may contract COVID-19, directly or indirectly, from the undersigned or such participating children) whether caused by the negligence, active or passive, of the Releasees or otherwise while the undersigned or such participating children are in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA.

The undersigned expressly and knowingly waives all rights under California Civil Code Section
1542, which provides: “A general release does not extend to claims that the creditor or releasing party does not
know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her,
would have materially affected his or her settlement with the debtor or released party.”
THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the
Releasees, and each of them, from any loss, liability, damages or costs they may incur, whether caused by the
negligence, active or passive, of the Releasees or otherwise while the undersigned or any participating child is in,
upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with
the YMCA. The undersigned understands and agrees that the YMCA is not required to provide insurance to
cover the undersigned or such participating children in the event they suffer illness, injury, death, property loss,
theft or damage of any sort upon, or about the premises or any facilities or equipment therein or participating in
any program affiliated with the YMCA.

ADDITIONALLY, THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY, DEFEND AND SAVE AND
HOLD HARMLESS the Releasees, and each of them, from and against any and all third-party claims, allegations,
suits, damages, losses, expenses, costs (including reasonable attorneys’ fees and costs), expert fees, or amounts payable under any judgment, verdict, court order, or court settlement to the extent resulting or arising out of: (a) the undersigned party’s negligence, tortious or illegal activity, or willful misconduct, or (b) any breach by the undersigned of this agreement including, but not limited to, any of the representations and warranties set forth in this agreement, while the undersigned or any participating child is in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA, that in any way causes or contributes to any COVID-19- related sickness of or injury to a third-party.

The undersigned agrees and acknowledges that use of the YMCA facilities and services, and participation in the
YMCA programs, may involve inherent danger and risk, including, without limitation, the risk of physical illness
or injury, death or property damage. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY
FOR, AND RISK OF ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned
or such participating children due to negligence, active or passive, of Releasees or otherwise while in, about or
upon the premises of the YMCA and/or while using the premises or any facilities or equipment thereon or
participating in any program affiliated with the YMCA. The undersigned acknowledges that any illness or
injuries that the undersigned or such participating children contract or sustain may be compounded by first aid
or emergency response of the Releasees and waive any claim in respect thereof.

The undersigned agrees and acknowledges that use of the YMCA facilities and services, and participation in the
YMCA programs, may involve inherent danger and risk, including, without limitation, the risk of physical illness
or injury, death or property damage. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY
FOR, AND RISK OF ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned
or such participating children due to negligence, active or passive, of Releasees or otherwise while in, about or
upon the premises of the YMCA and/or while using the premises or any facilities or equipment thereon or
participating in any program affiliated with the YMCA. The undersigned acknowledges that any illness or
injuries that the undersigned or such participating children contract or sustain may be compounded by first aid
or emergency response of the Releasees and waive any claim in respect thereof.

THE UNDERSIGNED further expressly agrees that the foregoing ASSUMPTION OF RISK, RELEASE AND
WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is
permitted by the law of the State of Colorado and that if any portion thereof is held invalid, it is agreed that the
balance shall, notwithstanding, continue in full legal force and effect.

I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND
WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL
REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN
AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I
AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES
FROM THE YMCA IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE,
INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO
COVID-19 AT ANY YMCA FACILITY OR PROGRAM AND ANY ILLNESS, INJURY OR DEATH
RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE
AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. IF SIGNING ON BEHALF OF
MINOR: I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR
CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT TO THE YMCA THAT I
HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).

I have read and understand the terms of this Assumption of Risk, Release and Waiver of
Liability, and Indemnity Agreement and agree to its terms.