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Students entered below will be added to your family's account
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Liability Waiver
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I, the participant, parent or legal guardian (individually and collectively referred to as my "Child") execute this Release and Waiver of Liability (the "Release"), as of the dated listed below, in favor of Little Flippers Swim, LLC, an Arizona limited liability company, its managers, members, directors, officers, employees, volunteer, and agents (collectively, "Little Flippers") In consideration for participating in Little Flippers' activities, I, hereby freely and voluntarily, without duress, execute the Release on behalf of me and my Child under the following terms: 1. Assumption of Risk. I understand, agree, and acknowledge that there are risks inherent in sporting activities conducted by Little Flippers including, but not limited to paralyzing injuries, brain injuries, and death. These activities may be of a hazardous nature and include strenuous exercise and vigorous physical activities. I am fully aware of the risks and hazards connected with the participation in this course, including physical injury, paralyzing injuries, brain injuries, and death, and herby elect to voluntarily participate in said event, knowing that the associated physical activity may be hazardous to me, my child, and my property. 2. Physical Condition and Disclosure. With the full understanding of the facts, I state, that to the best of my knowledge, my Child has no medical, physical, mental or emotional health condition which would hinder or prevent my child's active and full participation in this course. I have fully disclosed on the registration form any medical or health problems of which Little Flippers should be aware. I voluntarily assume full responsibility for any risks or loss, property damage, or personal injury, including death that may be sustained by me and/or my child, or loss or damage to property owned by me, as a result of participation in this course. 3. Waiver and Release. I release, agree not to sue and forever discharge and hold harmless Little Flippers from any claim or liability that I or my Child, may have against Little Flippers with respect to any bodily injury, personal injury, illness, death, or property damage that may result from my participation in activities with Little Flippers. I further agree to indemnify and hold Little Flippers harmless from and against any and all claims, actions, causes of action, liabilities, suits, expenses, costs (including attorney's fees) directly or indirectly arising out of or in any way connected with my Child's activities or being on the Little Flippers premises for activities. I also understand that Little Flippers does not assume any responsibility or obligation to provide financial or other assistance, including, but not limited to medical, health, or disability insurance, in the event of injury, illness, death or property damage (insurance requirements below). It is my expressed intent that this Release shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a release, waive, discharge of Little Flippers. 4. Insurance. I understand that Little Flippers does not carry or maintain, and expressly disclaims responsibility for providing any health, medical, or disability insurance coverage for my Child. I UNDERSTAND THAT I AM EXPECTED AND ENCOURAGED TO CARRY PERSONAL LIABILITY OR HEALTH INSURANCE FOR MY CHILD PRIOR TO REGISTERING MY CHILD IN ANY ACTIVITIES WITH LITTLE FLIPPERS. 5. Medical Treatment. In the event of a medical emergency, I hereby grant authorization to Little Flippers and its representatives, to employ any legally licensed physician or healthcare facility and to direct and/or order emergency medical treatment for my Child. I agree that neither Little Flippers, nor any of its representatives shall be liable under any circumstances to anyone for exercising the foregoing authority in the event of an emergency. Except as otherwise agreed to by Little Flippers in writing, I hereby release and forever discharge Little Flippers from any claim whatsoever that arises or may hereafter arise on account of any first-aid treatment or other medical services rendered to my Child in connection with an emergency during any activity with Little Flippers. I expressly agree that this Release is governed by the laws of the State of Arizona and is intended to be as broad and inclusive as is permitted by Arizona law, and that in the event any portion of this Release is determined to be invalid or unenforceable for any reason, the balance of the Release shall not be affected or impaired in any way and shall continue in full legal force and effect. This Release does not release or waive Little Flippers' liability or assume the risk of or indemnify Little Flippers from grossly negligent, willful, wanton or intentional acts or omissions of Little Flippers. I AM ENROLLING MY CHILD WITH LITTLE FLIPPERS WITH THE FULL KNOWLEDGE OF THE INHERENT RISKS, HAZARDS AND DANGERS INVOLVED, AND WILLINGLY ASSUME AND ACCEPT ANY AND ALL RISKS OF DAMAGE OR INJURY. I HAVE MADE A FREE AND DELIBERATE CHOICE TO SIGN THIS RELEASE AND WAIVER OF LIABILITY AS A CONDITION TO PARTICIPATING IN LITTLE FLIPPERS' ACTIVITIES. I HAVE CAREFULLY READ AND FULLY UNDERSTAND THE CONTENTS OF THIS AGREEMENT.
I've read the above and agree.
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Photographic Release
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I grant and convey unto Little Flippers all rights, title, and interest in any and all photographic images and video or audio recordings made by Little Flippers during my Child's activities with Little Flippers, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings (the "Photographic Release"). I waive any right to inspect the uses of any printed or electronic copy. I hereby release Little Flippers and its assigns from any claims that may arise from this conveyance of these rights, including, without limitation, claims of defamation, invasion of privacy, infringement of moral rights, rights of publicity, or copyright.
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: * |
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Name as it appears on card: * |
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Card Expiration Month: * |
Exp Year: *
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City:
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State:
Zip:*
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