Step 4
Payment & Waiver
Waiver and Release of Liability Agreement
Release and Waiver of Liability Agreement
READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD
ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF SWIMFULKIDS
USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE
SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN
DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED.
BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILDâS RIGHT AND YOUR RIGHT TO RECOVER FROM SWIMFULKIDS IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR
CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF
THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND SWIMFULKIDS HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.
WHEREAS, Ekinetic Corp., a Florida corporation d/b/a SwimfulKids (\\\\\\\"Company\\\\\\\") is the owner Company that provides the following activity: lesson, class, clinic, camp, evaluation, water safety program, recreational aquatic activity, event, or service offered by Company (the \\\\\\\"Activity\\\\\\\") and is willing to permit the minor children identified below (âParticipantâ), to participate in the Activity, upon the terms and conditions of this Agreement. All or some of the Activity may take place on a third-partyâs (âOperatorâsâ) Premises (defined below). The Company and Invitees may be collectively referred to as (the \\\\\\\"Parties\\\\\\\").
In consideration for being provided the ability to participate in the Activity, the undersigned, on his or her own behalf, and on behalf of Participant acknowledges, represents and agrees to the following conditions:
1. Parent or Guardian of Participant. I am the parent or legal guardian of the Participant or Participants named in the chart, below. I agree that the Participants shall comply with all stated and customary terms, posted safety signs, rules and verbal instructions, as conditions for participating in the Activity. If Participant(s) observe any hazard during their stay, they will immediately bring it to the attention of the nearest employee or staff member.
Participant Full Legal Name
DOB Medical Conditions, Allergies, Medications
2. Assumption of Risk. I understand and acknowledge that the Activity I want to permit Participant to participate in may be dangerous and may involve inherent and non-inherent risks, including but not limited to slips, falls, collisions, physical contact, panic, fatigue, swallowing water, waterborne illness, equipment failure, facility conditions, weather conditions, drowning, permanent disability, emotional distress, serious bodily injury, property damage, and/or death. I understand that the Activity may not be supervised and that the Company does not provide medical services. I further acknowledge that any injury Participant may sustain while participating in the Activity may be compounded by negligent or delayed medical service or negligent or delayed assistance by the Company. I, ON BEHALF OF PARTICIPANT, KNOWLINGLY, VOLUNTARILY, AND FREELY ASSUME ALL RISKS AND DANGERS BOTH KNOWN AND UNKNOWN, INCLUDING THOSE THAT MAY ARISE OUT OF THE (A) NEGLIGENCE OR CARELESSNESS ON THE PART OF THE PERSONS OR ENTITIES BEING RELEASED AND OTHER PARTICIPANTS, (B) DANGEROUS OR DEFECTIVE EQUIPMENT, OR (C) ANY OTHER CAUSE WHATSOEVER THAT MAY OCCUR PURSUANT TO PARTICIPANTS\\\\\\\' USE OF THE PREMISES AND PARTICIPATION IN ACTIVITIES ON THE PREMISES, INCLUDING THE RISK OF INJURY, DEATH, OR PROPERTY DAMAGE, EVEN IF CAUSED BY NEGLIGENCE OF THE COMPANY.
Furthermore, I authorize participation in the Activity and acknowledge that instructors may provide physical guidance, support, spotting, rescue assistance, flotation assistance, and other physical contact reasonably necessary for instruction, safety, or emergency response.
3. Release from Liability. I hereby agree, on behalf of myself, Participant, my and their heirs and my personal representatives, to fully and forever discharge and release Company and its affiliates, and their respective partners, agents, operators, managers, employees, and representatives together with Operator and its affiliates, and their respective partners, agents, operators, managers, employees, and representatives (individually and collectively, as context may require, the \\\\\\\"Released Parties\\\\\\\") from any and all claims I and/or Participant may have or hereinafter have for any injury, temporary or permanent disability, death, damages, liabilities, expenses and/or causes of action, now known or hereinafter known in any jurisdiction in the world, attributable or relating in any manner to my entry upon and use of the Premises and participation in the Activity, whether caused by the negligence or any other cause, of the Company or any of the Released Parties or by any other reason. I acknowledge and agree that this Release and Waiver of Liability for a Potentially Dangerous Activity is intended to be, and is, a complete release, as much as allowed by law, of any responsibility of the Released Parties for all personal injuries, temporary or permanent disability, death, and/or property damage sustained by me while on or using the Premises or participating in the Activity. This Agreement further extends to and benefits host facilities, schools, camps, synagogues, churches, religious institutions, country clubs, homeowners associations, condominium associations, community centers, municipalities, landlords, pool operators, property owners, management companies, and any location where Company activities occur (the âPremisesâ).
4. Covenant Not to Sue. I agree, for myself, Participant, and all my/their heirs, not to sue the Released Parties or initiate or assist in the prosecution of any claim for damages or cause of action against the Released Parties which I and/or Participant or my/their heirs may have as a result of any personal injury, death or property damage I and/or Participant may sustain while on or using the Premises or while participating in the Activity.
5. Indemnification. I hereby agree, on my behalf and/or Participantâs behalf, to defend, indemnify, and hold harmless Company and the Released Parties from and against any losses, damages, actions, suits, claims, judgments, settlements, awards, interest, penalties, expenses (including reasonable attorneys\\\\\\\' fees) and costs of any kind for any personal injury, loss of life or damage to property sustained by reason of or arising out of Participantâs use of the Premises or participation in any Activities on the Premises.
6. Medical Treatment Release. I hereby authorize the Company to secure, and I consent to, any medical treatment that may be given to me and/or Participant should the Company determine, in its sole discretion, that I and/or Participant need medical care, as a result of my and/or Participant being on the Premises or from participating in the Activity. I accept full responsibility for all costs related to my medical treatment, including any transport costs, and I release all parties involved from any type of liability for anything that may happen during my treatment or transport. Furthermore, I represent and warrant that Participant has medical insurance coverage.
7. Responsibility for Personal Property. I acknowledge and agree that I am fully and solely responsible for any of my property and personal belongings that I and/or Participant brings onto the Premises or that I and/or Participant use during the Activity, and that the Company will not be responsible for or provide any security for my and/or Participantâs property and personal belongings.
8. No Representations or Guaranty by Company. I acknowledge that Company makes no representation as to the condition of the Premises or the safety of the Activity or any equipment either on the Premises or used in the Activity. I accept and shall use, and cause Participant to use, the Premises, and its equipment, in its \\\\\\\"AS IS\\\\\\\" condition. I acknowledge and agree that I am not relying upon any representation or statement by the Company or the Company\\\\\\\'s employees, agents, sponsors, or representatives regarding this agreement or the Premises or Activity, except to the extent such representations are expressly set forth in this agreement. Furthermore, the undersigned understands that Company does not guarantee any specific swimming outcome, skill acquisition, water safety level, advancement, certification, behavioral improvement, competition result, or drowning prevention outcome. Swimming lessons reduce risk but do not eliminate risk, and children must continue to be actively supervised around water at all times.
9. Participantâs Medical Disclosure. The undersigned certifies that all medical, developmental, behavioral, allergy, medication, disability, sensory, and special-needs information provided to Company in Section 1 is accurate and complete. The undersigned agrees to immediately notify Company of any changes that may affect participation or safety.
10. Payments and Cancellations. To the extent applicable, sessions for Activity participation are billed in advance and reserve instructor time and class space. Missed classes do not roll over, accumulate, transfer, or carry forward. No-shows are considered attended classes. Make-up classes are not guaranteed and may be offered solely at the discretion of Company based upon availability. The undersigned acknowledges that Florida weather conditions may require cancellation, suspension, delay, relocation, or termination of classes. Classes affected by rain, lightning, thunderstorms, hurricanes, tropical storms, unsafe weather, pool contamination, water quality concerns, mechanical failures, governmental orders, force majeure events, facility closures, staffing shortages, emergencies, or circumstances beyond the control of Company are not guaranteed to be rescheduled and are not eligible for refunds unless required by law. Company reserves the right to modify schedules, assign instructors, substitute instructors, alter class formats, relocate activities, suspend participation, remove participants, or refuse service whenever Company determines that doing so is appropriate for safety, operational, business, facility, staffing, health, or behavioral reasons.
11. Data Collection & Privacy. The undersigned acknowledges that information may be collected for registration, scheduling, communication, billing, safety, attendance tracking, emergency response, and business administration. Company does not sell customer information but may share information with payment processors, scheduling providers, insurers, legal counsel, or service providers as reasonably necessary to operate the business.
12. Messaging and Communications. The undersigned consents to receiving communications from Company through telephone calls, text messages, email messages, WhatsApp, scheduling systems, billing systems, and other reasonable communication methods.
13. Likeness and Release. By signing this Agreement, the undersigned authorizes Company to photograph, videotape, record, livestream, and to edit, use, and reproduce my image, performance, voice, and/or physical likeness, as well as my personal information, including but not limited to my name and biographical information (individually and collectively, my \\\\\\\"Likeness\\\\\\\"). The undersigned grants Company a transferable, sublicensable, exclusive, perpetual, worldwide, irrevocable, royalty-free right to use such Likeness for advertising, marketing, educational, promotional, website, social media, public relations, training, and business purposes without compensation. The undersigned waives any right to inspect, approve, or receive compensation for such use.
14. Governing Law and Venue. This Release and Waiver of Liability agreement will be governed by and interpreted in accordance with the laws of the State of Florida, without giving effect to the principles of conflicts of law of such state. I agree that any action arising out of this Release and Waiver of Liability agreement must be brought exclusively in any state or federal court located in Broward County, Florida.
15. Waiver. No waiver of any term or right in this Release and Waiver of Liability agreement shall be effective unless it is in writing and signed by an authorized representative of the waiving party. The failure of any party to enforce any provision of this agreement shall not be construed as a waiver or modification of such provision, or impairment of its right to enforce such provision or any other provision of this agreement thereafter.
16. Survival. Any provision of this Release and Waiver of Liability agreement providing for performance by either party after termination of this agreement shall survive such termination and shall continue to be effective and enforceable.
17. Compliance with Laws. In the performance of the terms of this Release and Waiver of Liability agreement and use of the Premises, the parties shall comply with all applicable federal, state, regional and local laws, rules and regulations.
18. Severability. If any provision or portion of this Release and Waiver of Liability agreement shall be held by a court of competent jurisdiction to be illegal, invalid, or unenforceable, the remaining provisions or portions shall remain in full force and effect.
19. Entire Agreement; Modification; Binding Effect. This Agreement is the entire agreement between the parties with respect to the subject matter hereof and supersedes any prior agreement or communications between the parties, whether written, oral, electronic, or otherwise. No change, modification, amendment, or addition of or to this agreement shall be valid unless in writing and signed by authorized representatives of the parties. This agreement shall be binding upon and inure to the benefit of the successors, assigns, and legal representatives of the parties
[SIGNATURE PAGE TO FOLLOW]
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I HEREBY ACKNOWLEDGE THAT I HAVE FULLY READ AND UNDERSTAND EACH OF THE ABOVE PROVISIONS AND THAT I UNDERSTAND I AM GIVING UP SIGNIFICANT LEGAL RIGHTS OF MINE AND/OR PARTICIPANTâS, INCLUDING THE RIGHT TO SUE THE COMPANY. I ACKNOWLEDGE THAT PRIOR TO SIGNING THIS AGREEMENT I HAD THE OPPORTUNITY TO CONSULT WITH AN ATTORNEY TO REVIEW THIS AGREEMENT. I AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY COMPETENT, AND I EXECUTE THIS AGREEMENT VOLUNTARILY AND FOR ADEQUATE CONSIDERATION INTENDING TO BE FULLY BOUND.
I have read and agree to the Waiver and Release of Liability.
Parent / Natural Guardian Full Name
Relationship to Participant
Emergency Contact
Emergency Phone
Electronic Signature
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Payment Method
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