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Studio Liability Release
RELEASE AND WAIVER AGREEMENT
Name (Print):_______________________________
Date of Birth:_______________________________
I, the individual named above, am at least 18 years of age and desire to participate in the physical fitness, recreational and
other activities and programs provided by Meadowbrook Swim Club (“Meadowbrook”), which include but are not limited to
swimming, swimming classes, fitness programs and tennis, and to use Meadowbrook’s facilities including the swimming pools, physical
fitness rooms and shower areas. I understand that participation in Meadowbrook’s programs and activities and the use of
Meadowbrook’s facilities and equipment involve inherent risks that may result in personal injury, illness and even death. I voluntarily
choose to use Meadowbrook’s facilities and equipment, and I assume all responsibility and risk for any loss, damage, illness and injury
to person or property that I, in any way, may sustain, cause or incur in connection with such use.
I understand that it is solely my responsibility to be certain that I am physically fit and healthy enough to participate in the
activities and programs offered by Meadowbrook, and to decide whether to have a physical examination to determine my level of
fitness prior to participation.
In consideration of the opportunity to participate in Meadowbrook’s programs and activities and to use its facilities and
equipment and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged, I knowingly and
voluntarily hereby forever release Meadowbrook, its members, officers, instructors, coaches, employees, volunteers and agents, their
heirs, personal representatives, successors and assigns, and agree to indemnify and hold them harmless from any and all claims,
demands, causes of action, liability for personal injury, property damage or death caused by any reason whatsoever, arising or resulting
from my participation in Meadowbrook’s programs and activities and the use of its facilities and equipment.
This Release Agreement shall apply to the full term of my membership at Meadowbrook including any and all renewals and
extensions thereof.
By signing below, I am agreeing to abide by Meadowbrook’s Member Rules and Regulations. Meadowbrook reserves the
right to terminate the membership of any member who does not adhere to its Rules and Regulations.
If my application includes family members, as strictly described therein, and I am the parent or guardian or otherwise
responsible for any minor family member, I, on behalf of said family member, hereby release, discharge, agree not to sue, and do
indemnify and hold harmless Meadowbrook, its successors and assigns, and its members, officers, instructors, coaches, employees,
volunteers and agents, from and against any and all claims, demands, liabilities and causes of action of any kind on account of any
injury to, or illness or death of, said family member as a result of his/her participation in Meadowbrook’s activities or programs or
the use of Meadowbrook’s facilities or equipment whether due to the negligence or other action or inaction of any person or entity.
I HAVE READ THE ABOVE RELEASE AGREEMENT, UNDERSTAND THAT I AM GIVING UP AND WAIVING SUBSTANTIAL RIGHTS
BY SIGNING IT, AND SIGN IT VOLUNTARILY WITH FULL KNOWLEDGE AND UNDERSTANDING OF ITS SIGNIFICANCE.
Member Signature: _______________________________________________
Dated: __________________________