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Waiver of Liability
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Contact Number
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Name of Participant
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I am not aware of any medical condition or other circumstances that may affect my ability to participate in the Learn to Swim Program; and I have not consumed any alcoholic beverages or illegal substances prior to participating in the Learn to Swim Program.The terms and provisions of this instrument shall be binding upon the heirs, executors or administrators of the undersigned. I certify that I have read the foregoing and am responsible for my actions. Initial Below
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I certify that (a) I am 18 years of age/older or (b) am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release. Electronic Signature Below:
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Waiver of Liability Relating to Coronavirus/COVID-19
Name of participant (printed)
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Fajr Memorial Foundation and Boy’s Club of New York cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while utilizing Fajr Memorial Foundation and Boy’s Club of New York’s services or premises. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Fajr Memorial Foundation and Boy’s Club of New York’s services and/or enter onto Fajr Memorial Foundation and Boy’s Club of New York’s premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19. Initial Below
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ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in order to utilize Fajr Memorial Foundation and Boy’s Club of New York’s services and enter Fajr Memorial Foundation and Boy’s Club of New York’s premises. These services are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Fajr Memorial Foundation and Boy’s Club of New York’s services and premises in person. Initial Below
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WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Fajr Memorial Foundation and Boy’s Club of New York and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Fajr Memorial Foundation and Boy’s Club of New York’s services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen. Initial Below
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CHOICE OF LAW: I understand and agree that the law of the State of New York will apply to this contract. Initial Below
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I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE: Electronic Signature Below
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I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.
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