Acknowledgment and Release
Important: Read this release. It affects your rights.

In consideration of the continued right to use the swimming pool, tennis courts, playground equipment, or any surrounding premises of the North Canyon Swim & Tennis Club (collectively, the ‘Premises’) the member hereby:

1. Acknowledges that he/she has received copies of the by-laws and rules. That he/she consents to abide by all by-laws and rules in accordance with their provisions.

2. Releases North Canyon and its employees, independent contractors, officers and directors, of and from all liability, claims, demands, actions, and causes of action whatsoever, arising out of or relating to any loss, damage, illness or injury, including death, which may be sustained by the Member, child of the Member, or any property while in, on, or upon the Premises.

Each member is aware of the risks and hazards inherent upon the Premises, and in participating in activities on the premises. Such risks and hazards include, without limitation, slipping on wet surfaces, striking the diving board or bottom of the pool when jumping or diving into the pool, stepping on broken glass or other sharp objects, accidents caused by rough play by the Member, the child of the Member and/or others, getting infections and/or communicable diseases from others also using the Premises, injuries from structural defects or condition of the Premises, and death by drowning or otherwise. Each Member knows of the present condition of the Premises and knows the Premises may become more hazardous and dangerous during the time the Member, the child of the Member and/or others are using the Premises. Each Member is aware of the Member’s, or the child of the Member’s ability and capacity to swim and otherwise use the Premises in a safe manner. Each Member is aware that a lifeguard may not be present at all times and that no first aid care is available on the Premises. Each Member is aware that children have no authority or permission to use the Premises without careful supervision of an adult, except in accordance with the Swimming Competency Standard set forth below. Each Member is aware and the child(ren) listed herein have been advised that he/she must obey the rules of North Canyon Swim & Tennis Club as they exist from time to time and the rules posted on the Premises and must cooperate with the lifeguard and others in authority while on the Premises at all times.

This Acknowledgment and Release shall be binding upon the distributes, heirs, next of kin, executors, guardians, administrators, successors, and assigns of each Member.

In signing this Acknowledgment and Release, each Member hereby acknowledges and represents:

1. That the Member has read the foregoing Acknowledgment and Release, understands it, and signs it voluntarily;

2. That the Member who is the parent or guardian of the child(ren) listed has authority to sign on behalf of such child(ren);

3. That the Member and the Member’s child(ren) each understands or has been advised of the risks and rules for safety using the Premises; and that the Member and the Member’s child(ren) has sufficient skills to properly be at the Premises.

Pool Attendance and Swimming Competency Standard

All children under 8 years old or any child not deemed water safe by a North Canyon Swim & Tennis Club lifeguard or employee must be accompanied by an adult or responsible water safe child age 14 or older.


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Parent/Guardian Name *
(The responsible party filling out this form)
Address *
Phone *
(The best one to reach you in case of emergency)
Member's Name
(If visiting as the guest of a club member)
Name 1
Age 1
Name 2
Age 2
Name 3
Age 3
Name 4
Age 4
Name 5
Age 5
Signature (your full name) *
Typing your full name here acknowledges that you have read and agree to the above terms.
Date *
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