947 Swim Liability/Covid-19 Waiver Form
Email *
Participants Name *
Name of Parent or Guardian if under the age of 18 *
Aquatic programs attending *
Program Date(s) and Time(s) *
(e.g. July 1-7, 2021 @4:30pm)
Phone Number *
By registering with 947 Swim, the legal parent/guardian of the registered participant(s) on their own behalf and on behalf of the participant(s) hereby agrees that 947 Swim, and the facilities operators rented by 947 Swim, are released from any and all liability, claims, demands, and causes of action whatsoever arising out of, or related to, any loss, damage, or injury, including death, that may be sustained by the participant(s) and/or the undersigned, while in or upon the premises or any premises under the control and supervision of 947 Swim instructors, staff, volunteers and any facilities operated by 947 Swim. *
I understand, agree, and acknowledge that there are risks inherent in sports activities conducted by 947 Swim, including but not limited to paralyzing injuries, brain injuries, and death. These activities may be hazardous, including activities such as swimming, diving, strenuous exercise and physical activities. With the full understanding of the facts, I agree to assume these risks and I state that to the best of my knowledge, my son/daughter listed as participant has no medical, physical, or emotional health conditions that would hinder or prevent his or her participation in swim instruction by 947 Swim. *
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, provincial, and municipal governments and public health authorities recommend social distancing and have, in many locations, prohibited the congregation of groups of people. 947 Swim has put in place preventative measures to reduce the spread of COVID-19 through the 947 Swim Covid-19 Safety Plan; however, 947 Swim cannot guarantee that you or your child(ren) will not become infected with COVID-19. Attending 947 Swim Programs could increase your risk and your child(ren)’s risk of contracting COVID-19. By registering with 947 Swim, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending 947 Swim programs that such exposure or infection may result in personal injury, illness, permanent disability, and death. I have read and agree to follow the 947 Swim Covid-19 Safety Plan that outlines the policies and procedures that have been put in place by 947 Swim to reduce the risk of Covid-19 transmission. I understand that the risk of becoming exposed to or infected by COVID-19 that may result from the actions, omissions, or negligence of myself and others, including, but not limited to, 947 Swim facility operators, instructors, swimmers, program participants and their families. By registering with 947 Swim, the legal parent/guardian of the registered participant(s) on their own behalf and on behalf of the participant(s) hereby release, covenant not to sue, discharge, and hold harmless 947 Swim, owners of the pool, of and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of 947 Swim, owners of the pool and facilities operated by 947 Swim whether a COVID-19 infection occurs before, during, or after participation in any 947 Swim programs. *
Participant Signature or Parent/Guardian *
By confirming my full name below, I agree that the signature will be an electronic representation of my signature.
A copy of your responses will be emailed to the address you provided.
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