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HomeMy Public PortalAbout140_050_Gymnasium Guest Information form 07 21 11 Gymnasium Guest Information AND RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT Name: ____________________________________________ Date of Birth: _____________________________ Address: __________________________________________ City: _____________ State: _____ Zip: ________ Phone: ___________________________________ Driver’s License Number: ____________________________ FACILITY USAGE POLICY - All guests are required to show a state issued ID. Guests without a photo ID will not be allowed to use the facility. - All guests are required to complete the Guest Registration form and pay facility fee of $5.00. - All guests understand and acknowledge that half of the City of Tybee Gymnasium is reserved for Tybee Island residents and YMCA members at all times. - All guests are expected to maintain themselves in a respectful manner towards property, other patrons, staff and the facility. Any guests not abiding by the facility rules will be asked to leave the property immediately and no refund will be issued. - No food or drinks are allowed in the gymnasium. - For guests using locker room or showers, a gymnasium form must be filled out and facility fee paid. RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT IN CONSIDERATION of being permitted to enter the City of Tybee Island Gymnasium for any purpose, including but not limited to, observation, use of facilities or equipment, or participation in any events in any way, the undersigned, for himself or herself, his or her heirs, successors, representatives, administrators and assigns does hereby release the City of Tybee Island, its elected officials, agents, volunteers employees, and officers and the YMCA and all of its representatives, agents, volunteers, employees, successors and assigns from actions, causes of action, suits of any type or nature whatsoever, whether in law or in equity, arising out of or relating to any loss, damage, or injury, including death, that may be sustained by the undersigned or which in any way relates to the undersigned’s entry into the gymnasium premises and/or the facilities or equipment therein. Also, the undersigned for himself or herself, his or her heirs, successors, heirs, agents and assigns agrees and covenants to refrain from bringing or causing to be brought any claims, demands, actions, suits, or other proceedings, whether at law or in equity, or whether before a court, arbitration panel, agency, or board, or other body against the City of Tybee Island or the YMCA or any director, officer, employee, agent, or volunteer of the City of Tybee Island or the YMCA or of the foregoing entities, individually or in any combination thereof on account of any and all rights, demands, damage, claims, actions, causes of action, duties or breach of duty, known or unknown, existing, pending, accrued or unaccrued which the undersigned has, claims to have, or may have to the extent any such cause of action arises from this agreement or performance under this agreement. The undersigned shall indemnify, protect, save and hold harmless the City of Tybee Island and the YMCA, and the directors, officers, employees, agents, and volunteers of such entities (hereinafter the “indemnified parties”) from and against any and all claims, demands, judgments, setoffs, losses, damages, liabilities, awards, fines and expenses, including without limitation, the concurrent negligence of one or more of the indemnified parties and the undersigned, the contributory negligence of one or both of the indemnified parties and any third party, and any attorney’s fees, expenses, or other costs associated with or incurred based on or in any manner arising out of or related to the performance or non-performance of this agreement or the exercise of any rights granted to the undersigned hereunder, including but not limited to, injury to persons or property, actual damages, consequential damages, punitive damages, losses, setoffs, warranty claims, product liability claims, or other damages arising out of an action for strict liability in tort; provided, however, that nothing contained in this provision shall be interpreted to indemnify or hold harmless one or more of the indemnified parties against liability for damages arising out of bodily injury to persons or damage to property caused by or resulting from the sole negligence or willful misconduct of the indemnified parties or their agents, employees, or volunteers. Without limiting the foregoing indemnity, the undersigned shall indemnify the indemnified parties for all defense costs, including reasonable attorney’s fees, and amounts paid in settlement. The undersigned acknowledges that he or she has inspected the premises and facilities of the Tybee Island Gymnasium and acknowledges that entry into the gymnasium for observation, participation, or use of any facilities or equipment constitutes an acknowledgment that such premises and all facilities and equipment therein have been inspected and that the undersigned finds and accepts same as safe and reasonably suited for the purposes of such observation or use. The undersigned hereby elects, voluntarily, to participate as an observer or participant and assumes all risk of loss, damage, or injury, including death, that may be sustained by the undersigned, or his or her property, from participating in said observation or use. The undersigned further expressly agrees that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Georgia and that if any portion hereof is held invalid, it is agreed that the balance hereof shall continue in full force and effect. THE UNDERSIGNED HAS/HAVE READ AND VOLUNTARILY SIGNS THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations or statements or inducements, apart from the foregoing written agreement, have been made. I HAVE READ THIS RELEASE: ___________________________________________________________ (Signature of Applicant/Parent/Guardian if under 18) DATE: __________________________________