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TERMS & CONDITIONS:
Prior to any physical activity, we recommend that you consult your family physician. In consideration of my participation in the activities of the Raritan Bay Area YMCA, I do hereby agree to hold free from any and all liability the Raritan Bay Area YMCA and its respective officers, employees and members and do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages which I may hereafter accrue to me arising out of or connected with my participation in any activities of the Raritan Bay Area YMCA.
RELEASE AND WAIVER OF LEGAL LIABILITY
THIS IS YOUR RELEASE AND WAIVER OF LIABILITY (the “Release”). You individually and on behalf of any minor child, release the Raritan Bay Area YMCA, its officers, directors, board members, employees, volunteers, agents, independent contractors, other participants and/or others acting on its behalf (collectively, “YMCA”).
This is important to you and any minor children, so do not sign until you have had your questions answered. You provide this release freely, voluntarily, and without duress under the following terms:
1) GENERAL RELEASE, INDEMNIFICATION AND HOLD HARMLESS:
I hereby agree for myself and my child and our respective heirs, assigns and legal representatives, to indemnify, defend and hold YMCA and its officers, directors, board members, employees, volunteers, agents, independent contractors and other participants (“Releases”) the YMCA Program harmless from any and all claim and causes of action of any nature for any and all personal injury or illness, including death, which may occur to my child or which may be aggravated during or by any activity during the course of the YMCA Program in which I have decide to allow [myself or my child] to engage. I further waive any and all claims or causes of action which I or my child may now or hereafter have against YMCA which may at any time arise as a result of any act or thing occurring in or arising out of [my or my child’s] participation in the YMCA program. I further expressly understand and agree the foregoing indemnity, release and waiver is intended to be as broad and inclusive as permitted by the law of the State of New Jersey and any portion thereof is held invalid, it is agreed the balance shall, notwithstanding, continue in full force and effect.
2) ASSUMPTION OF RISK:
I, individually and/or on behalf of any minor child(ren), expressly and specifically assume any and all risk of injury, illness, death, or property damage resulting from the YMCA program. You assume the risks: I, individually and on behalf of my minor child(ren),understand the YMCA activities are strenuous and dangerous. I understand the activity should be engaged in only by persons in good health. I understand I should consult a physician before enrolling myself or my child(ren) in the YMCA program. Once you sign, you are saying you understand the risks involved and accept all of the risks. You acknowledge the YMCA is a charitable organization and you are a beneficiary of the YMCA.
3) MEDICAL RELEASE:
I, individually or on behalf of any minor child(ren), hereby release YMCA from any claim whatsoever which may arise as a result of any first aid, treatment, or services or assistance provided to me or my minor child(ren) in connection with any injury that arises from the YMCA program. A) I take full responsibility for my welfare and safety as well as my child(ren) during the YMCA program. B) I hereby give permission for emergency medical treatment to be administered as deemed appropriate.
4) INSURANCE: YOU ARE EXPECTED TO HAVE YOUR OWN HEALTH AND ACCIDENT INSURANCE.
You should understand the YMCA does not carry insurance to cover injuries and losses that may befall you.
5) PHOTOGRAPHIC RELEASE:
I consent to be photographed and to allow YMCA’s use of any photos of me or my minor child(ren) at its sole discretion. You Release YMCA from any obligations to you or your heirs or assigns for such photographs, specifically releasing YMCA from any obligation to pay a fee or royalties for any use of your photographic image.
YMCA program participant(s) must sign as “Applicant(s)”. “Applicant(s)” under the age of 18 must have the signature(s) of both Parents/Legal Guardians sign “Individually and as Parent and/Legal Guardian”. “Applicant; Applicant 2, Applicant 3;” refers to the individual who is the participant in. If there are multiple “Applicants” from the same family participating in YMCA program, each must sign individually.
CREDIT CARD AUTHORIZATION:
I authorize my bank or credit card institution to honor preauthorized monthly charge drawn by the Raritan Bay Area YMCA on my account for membership payments as indicated. When the bank honors the credit card by charging my account, such transfer shall constitute notice of payment due and my receipt for the payment. Should any preauthorized EFT or credit card not be honored by said bank or credit card institution, when received by them, then it is understood that the payment is to be made by me in the amount of said payment plus a $30 service charge. The Raritan Bay Area YMCA will debit the monthly membership fee on the 1st or 15th of each month. I understand that I must set up monthly credit card draft for my YMCA Membership.
I understand any and all fees associated with the collection of fees or any other amounts due to the RARITAN BAY AREA YMCA will be my responsibility. I agree to reimburse the RARITAN BAY AREA YMCA for the fees of any collection agency which may be based on a maximum of 67% of the debt, plus all cost and expenses including reasonable attorney fees we incur in such collection efforts.
HAVING READ, UNDERSTOOD, AGREED WITH, AND ACCEPTED THESE TERMS, I EXECUTE THIS RELEASE, TO BE EFFECTIVE IMMEDIATELY.
NOTE: You must fill in your First and Last name, agreeing to the terms above prior to moving to the next page. Thank you!