Town of Strathmore - Liability Waiver Form-

Waiver Form For Use of Town of Strathmore Recreation Facilities

This waiver must be signed by all participants using a Town of Strathmore Recreation Facility (Family Centre, Aquatic Centre, Strathmore Motor Products Sports Centre) at the time of drop-in, membership purchase, or enrollment in a class or lesson. All individuals entering the facility for recreational purposes who are not covered under a facility booking contract MUST sign this waiver prior to entry. Entry will not be permitted without completion of the waiver. Once signed, the waiver remains valid for all aforementioned facilities. This form must be filled out by the legal parent or guardian.

Step 1: Parent / Adult Information

First name *

Last name *

Email *

Mobile *

Step 2: Participant / Child Info (Click the red X if you are not legal guardian)

This section is for participating minors (ages 17 or under)or 18 plus who have a legal guardian. If you are 18 or over, you only need to complete Step 1 above. To add additional children, click the +Add button. You must be the legal parent or guardian of the participant.

First name *

Last name *

Gender Please specify

Date of birth *

RELEASE OF LIABILITY, WAIVER OF CLAIMS,

ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

WARNING: BY SIGNING THIS LEGAL DOCUMENT, YOU GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE, CLAIM DAMAGES, AND SEEK COMPENSATION.

I/We, the undersigned Participant(s), am aware that the use of Town of Strathmore facilities (the “Facilities”) involves inherent risks, dangers and hazards that may result in all manner of injury or loss, including potentially serious or life-threatening injury and death, resulting from:

(a) the use of equipment, materials or facilities;

(b) the actions or negligence of the Participant or other participants or users of the Facilities;

(d) the actions or negligence of the Town of Strathmore or its council, officers, employees, agents, invitees, or representatives of any kind (collectively referred to as the "Municipality"); or

(e) additional risks arising out of the use of the Facilities and related events and activities.

I/We the undersigned Participant(s), and/or the parent(s) and/or guardian(s) freely accept and assume all such risks, dangers and hazards and the possibility of injury, death, property damage, property loss or any other loss or expense resulting to myself and hereby agree as follows:

(a) TO WAIVE ANY CLAIMS AND RELEASE THE MUNICIPALITY from any and all liability for injury, death, property damage, property loss or any other loss or expense that I may suffer or that respective next of kin or legal representatives may suffer as a result of use of the Facilities, due to any cause whatsoever, including negligence on the part of the Municipality; and

(b) TO HOLD HARMLESS AND INDEMNIFY THE MUNICIPALITY from any and all liability for injury, death, property damage, property loss or any other loss or expense to any party, including myself, as a result of the use of the Facilities, or other financial loss or expense including, without restriction, legal expenses and costs on a solicitor-and-his-own-client full indemnity basis in defending against such claims or enforcing the terms contained within this document.

I/We, the undersigned Participant(s), and/or parent(s) and/or guardian(s) further confirm that my physical condition and fitness are adequate for participation in the activities offered by the Facilities.

I/We, the undersigned Participant(s), and/or parent(s) and/or guardian(s) agree to comply with all rules, regulations and instructions of the Facilities, and consent to receive any and all medical treatment which operators of the Facilities consider advisable in the event of an illness or injury suffered by myself during the use of the Facilities.

I/We, the undersigned Participant(s), and/or parent(s) and/or guardian(s), hereby acknowledge that I have read the foregoing, and have had the opportunity to ask questions and clarifications before signing, and have explained its meaning to the Participant. I acknowledge that I understand its content, import and meaning and hereby do agree, approve and consent to the above.

I read and accept *

Please read and scroll to the bottom to accept.

Step 3: Confirm Information *

Have you read all Sections of the waiver, and do you agree to its terms?

Step 3: Confirm Information YES!

I have read all sections of this waiver in its entirety, am in a right state of mind, and agree to its terms. I also understand that checking the box above and signing below will act as a legal and valid signature.

Step 4: Memberships *

I acknowledge that all memberships are non-transferable. Please note that 10-punch and 30- punch passes are non-refundable. Annual, 6-month, 3-month and 1-month memberships may be prorated in special circumstances, such as medical issues (with a dated doctor's note) or job relocation (with a signed company letter indicating the relocation dates). Additionally, please be aware that a cancellation fee of $23.71 will apply

Yes x Clear

Step 5: Transfer Fee *

I acknowledge: Should you require a transfer of programs there is a $11.72 transfer fee.

Yes x Clear

Step 6: Cancellation Fee *

I acknowledge: Cancellation Policy: Cancellations submitted in writing at least 7 business days before the program begins are eligible for a refund, minus a $23.71 administrative fee. Requests for cancellation made less than 7 days prior to the start of the program will not be eligible for a refund. Please note Special Event Programs may be slightly different, this will be posted with the program.

Yes x Clear

Step 7: Photos *

I acknowledge that photographs are necessary for membership registration.

I give my consent for photographs and/or videos to be taken of me during my participation in activities within the controlled recreational area. I also permit the Releasees to use these images for advertising, promotional, and marketing purposes.

I understand that specific programs such as swim lessons, camps, and group fitness classes may require additional consent. I have the option to decline media coverage if preferred.

Yes x Clear

Step 8: Electronic signature*

Please use your mouse or finger to sign your name in the box below

Type your name

Signature style

Step 8: Electronic signature Signature pad

The information on this form is being collected in accordance with the Municipal Government Act and will be managed in compliance with the Access to Information Act (ATIA) and the Protection of Privacy Act (POPA). If you have any questions about the collection of your information, please contact the Town of Strathmore's ATI Coordinator at 403-934-3133.

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