Apr 08

YMCA Liability Waiver

To download free Liability waiver form in PDF, please click YMCA Liability Waiver


YMCA OF SILICON VALLEY
RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
IN CONSIDERATION of being permitted to utilize the facilities, services and programs of the YMCA (or for
my children 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, for himself
or herself and such participating children and any personal representatives, heirs, and next of kin, hereby
acknowledges, agrees and represents that he or she has, or immediately upon entering or participating will,
inspect and carefully consider such premises and facilities or the affiliated program. It is further warranted that
such entry into the YMCA for observation or use of any facilities or equipment or participation in such affiliated
program constitutes an acknowledgment that such premises and all facilities and equipment thereon and such
affiliated program have been inspected and carefully considered and that the undersigned finds and accepts
same as being safe and reasonably suited for the purpose of such observation, use or participation by the
undersigned and such children.
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 OFF-SITE
PROGRAM AFFILIATED WITH THE YMCA, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:
1. THE UNDERSIGNED, ON HIS OR HER BEHALF AND BEHALF OF SUCH CHILDREN, HEREBY RELEASES, WAIVES,
DISCHARGES AND CONVENANTS NOT TO SUE the YMCA, its directors, officers, employees, and agents
(hereinafter referred to as “releases”) from all liability to the undersigned or such children and all his personal
representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on
account of injury to the person or property or resulting in death of the undersigned, whether caused by the
negligence of the releases or otherwise while the undersigned or such children is in, upon, or about the premises
or any facilities or equipment therein or participating in any program affiliated with the YMCA.
2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releases and each
of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned or such
children in, upon or about the YMCA premises or in any way observing or using any facilities or equipment of the
YMCA or participating in any program affiliated with the YMCA whether caused by the negligence of the releases
or otherwise.
3. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR
PROPERTY DAMAGE to the undersigned or such children due to negligence of releases 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 further expressly agrees that the foregoing RELEASE, WAIVER AND INDEMNITY
AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of California and
that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full
legal force and effect.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND
INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducement apart from
the foregoing written agreement have been made.
I HAVE READ THIS RELEASE.
__________________________________________________________ __________________________________________________________
Signature of Applicant/Parent Date Print Name of Child in Program Date
__________________________________________________________ __________________________________________________________
Print Name of Applicant/Parent Date Print Name of Child in Program Date
__________________________________________________________ __________________________________________________________
Signature of Applicant/Parent Date Print Name of Child in Program Date
__________________________________________________________ __________________________________________________________
Print Name of Applicant/Parent Date Print Name of Child in Program Date

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