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Coach Leona Bently of the Dublin Sea Dragons will share her extensive knowledge of the sport in this small group setting. Swimmers will work on improving their start technique to better maximize their speed off the blocks. Swimmers should be comfortable going off of the blocks before enrolling in this clinic.

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	First Name:*	Last Name: *
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Additional Information:

Release of Liability

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I, the participant and/or parent/guardian, request voluntary participation in swimming classes, which are hereinafter referred to as the “activities.” sponsored by LK Aquatics dba Buckeye Swim School. I consent to my/minor’s participation in the activities and acknowledge that the minor and I fully understand my/minor’s participation may involve risk of serious injury or death, including losses which may result not only from my/minor’s own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, the condition of the facilities, equipment, or areas where the event or activity is being conducted, and/or the rules of play of this type of event or activity. I understand that if I have any risk concerns, I should discuss the risks associated with my participation with the activity coordinators and event staff, before I sign this document and before any activities begin.

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Release – Minor’s Rights

In consideration of allowing Minor Participant to participate in the activities, I hereby release and hold harmless LK Aquatics, LLC, and its board of directors, officers, employees, volunteers, other participants, and agents (collectively, the “Released Parties”), of and from, and do discharge and waive, any and all claims, demands, losses, damages, and liabilities that Minor Participant may have or sustain with respect to any and all damage and/or injury, of any type, arising out of his or her participating in the activities. I also agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

Release – Parents’/Guardians’ Rights

In consideration of allowing Minor Participant to participate in this event, I hereby release and hold harmless the Released Parties, of and from, and do discharge and waive, any and all claims, demands, losses, damages, and liabilities that I may have or sustain with respect to any and all damage and/or injury, of any type, arising from Minor Participant’s participation in the activities. I also agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect. I certify that my/minor is in good health and has no physical condition that would prevent participation in this activity. Furthermore, I agree to use my/minor’s personal medical insurance as a primary medical coverage payment if an accident or injury occurs. If the Minor Participant receives a new diagnosis that may impact their safety, learning, or other aspects of the activity, the parent/guardian shall notify the swim school in writing or via email.

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Consent for Medical Treatment

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In the event of a medical emergency, I, the undersigned participant or parent/guardian of the participant, authorize Buckeye Swim School and its representatives to direct and/or order emergency medical treatment, and to employ any legally licensed physician, emergency medical services, or health care facility for the participant. I also agree that LK Aquatics dba Buckeye Swim School nor its representatives are liable under any circumstances to anyone for exercising the foregoing authority in the event of an emergency.

Indemnification by Parent/Guardian

The undersigned parent/guardian further agrees to indemnify, save and hold harmless the Released Parties from any and all claims, demands, losses, damages, and liabilities for indemnities, contribution, or otherwise with respect to any damage and/or injury, of any type, arising from Minor Participant’s participation in the activities. The undersigned also agrees that this Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement extends to all acts of negligence by the Releasee and is intended to be as broad and inclusive as is permitted by the laws of the State in which the Event(s) is/are conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notw

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