Liability Waiver. I UNDERSTAND THAT THERE MAY BE RISKS ASSOCIATED WITH THE ABACOA COMMUNITY GARDEN. By signing below, I hereby represent that I am familiar with and assume all risks in any way associated with my participation (or the participation of my minor child) in the above-referenced club/activity which has been organized, sponsored, or endorsed in any manner by Abacoa Property Owners’ Assembly, Inc. (the “APOA”), and I hereby release the APOA and Renewal Church, their employees, licensees, members, agents, directors, officers, managers, and management company as well as any member of the garden (collectively the “RELEASEES”) from any and all claims for damages for personal injury, death, or property damage of any kind which may hereafter accrue to me (or my minor child, if I have signed below for a minor) or any person, as a result of, or in any way related to, my (or said minor’s child’s) participation in, or presence at, the above-referenced activity at any time. This release from liability also releases the RELEASEES from any liability or claims related to the use of photographs or videos, for publicity purposes related to the Abacoa clubs/activities, of the undersigned participant (and any minor child the undersigned is signing this document on behalf of). This assumption of risks and release from liability shall be binding on my (and said minor’s child’s) heirs and assigns, and shall operate to bar all claims against the RELEASEES regardless of whether liability may arise out of negligence or carelessness of the RELEASEES. If you are interested in an Individual Plot, contact Xxxxxx Xxxxxxx xxxxxxxxxxx@xxxxx.xxx for information and availability. Name: Address: Preferred Phone: E-mail: (*For Full Size Renewal ONLY. ½ Sized Plot: $45 Table Top Bed: $35 Abacoa Community Garden c/o Abacoa POA, Inc. 0000 Xxxxxxxxxx Xxxx. Suite 102 Jupiter, FL 33458
Appears in 2 contracts
Samples: Membership Agreement, Membership Agreement
Liability Waiver. I UNDERSTAND THAT THERE MAY BE RISKS ASSOCIATED WITH THE ABACOA COMMUNITY GARDEN. By signing below, I hereby represent that I am familiar with and assume all risks in any way associated with my participation (or the participation of my minor child) in the above-referenced club/activity which has been organized, sponsored, or endorsed in any manner by Abacoa Property Owners’ Assembly, Inc. (the “APOA”), and I hereby release the APOA and Renewal Church, their employees, licensees, members, agents, directors, officers, managers, and management company as well as any member of the garden (collectively the “RELEASEES”) from any and all claims for damages for personal injury, death, or property damage of any kind which may hereafter accrue to me (or my minor child, if I have signed below for a minor) or any person, as a result of, or in any way related to, my (or said minor’s child’s) participation in, or presence at, the above-referenced activity at any time. This release from liability also releases the RELEASEES from any liability or claims related to the use of photographs or videos, for publicity purposes related to the Abacoa clubs/activities, of the undersigned participant (and any minor child the undersigned is signing this document on behalf of). This assumption of risks and release from liability shall be binding on my (and said minor’s child’s) heirs and assigns, and shall operate to bar all claims against the RELEASEES regardless of whether liability may arise out of negligence or carelessness of the RELEASEES. If you are interested in an Individual Plot, contact Xxxxxx Xxxxxxx xxxxxxxxxxx@xxxxx.xxx for information and availability. Name: Address: Preferred Phone: E-mail: (*For Full Size Renewal ONLY. ½ Sized Plot: $45 Table Top Bed: $35 Abacoa Community Garden c/o Abacoa POA, Inc. 0000 Xxxxxxxxxx Xxxx. Suite 102 Jupiter, FL 33458
Appears in 1 contract
Samples: Membership Agreement
Liability Waiver. I UNDERSTAND THAT THERE MAY BE RISKS ASSOCIATED WITH THE ABACOA COMMUNITY GARDEN. By signing belowIn consideration of participating in any activity at Elkhart Health & Aquatics, I hereby represent understand the inherent risks of participation. I understand that I shall discontinue participating should I believe the conditions are unsafe at any time. I further agree and acknowledge that I am familiar with and assume assuming all risks in any way associated with being injured or disabled while participating in this program in or outside of Elkhart Health & Aquatics. Having read this waiver and knowing these facts and in consideration of your accepting this application, I for myself and anyone entitled to act on my participation (or the participation of my minor child) in the above-referenced club/activity which has been organizedbehalf, sponsoredwaive and release Beacon Health System, or endorsed in any manner by Abacoa Property Owners’ AssemblyInc., Inc. (the “APOA”)Elkhart Fitness, Health & Aquatics, Inc., and I hereby release the APOA and Renewal Churchall its sponsors, their employees, licensees, membersrepresentatives, agents, directors, officers, managersemployees, volunteers and management company as well as any member of the garden (collectively the “RELEASEES”) successors from any and all claims for claims, liabilities, demands, losses, cause of action or damages for personal injuryof whatever kind or nature arising from or based upon in any way my participation in the Elkhart Health & Aquatics program, deathwhich may be caused in part by the negligence or carelessness on the part of the organizations or persons named in this waiver. I will also indemnify, save and hold harmless all organizations or individuals named from any loss, liability, damage or cost which may be incurred by such organization or individuals arising from or based upon my acts or negligence during my participation in this event. In addition, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or property damage any other record of this user agreement for any legitimate purpose. By visiting a Beacon Health & Fitness facility, including Elkhart Health & Aquatics, I acknowledge that there is risk of contracting a communicable disease including, but not limited to COVID-19, and others. While Beacon Health & Fitness makes efforts to reduce these risks, you acknowledge that you understand that this risk remains. I certify that I am 18 years of age or older, or that I am the Parent/Guardian of the participant and am granting permission for him/her to participate. I have read the liability waiver and understand the inherent risks with this activity. Initial: RULES & REGULATIONS: I have read the Rules & Regulations listed on the back of this form and agree to the listed items. Initial: WEAPONS: Dangerous weapons of any kind which are not permitted at any Beacon Health & Fitness facility, including Elkhart Health & Aquatics, except by people authorized by law to carry a weapon in the performance of their duties, such as city, county, state, Beacon security/police, contracted private security personnel or federal law enforcement officers. Failure to adhere will result in immediate and permanent revocation of access to any of our facilities. Dangerous weapons are defined as any of the following, but not limited to: firearms, knives, Tasers, daggers, straight razors or sword-in-canes. In various circumstances, weapons may hereafter accrue also include any other article used in such a manner as to me (or my minor child, if cause serious physical injury. I have signed below for a minor) or any person, as a result of, or in any way related to, my (or said minor’s child’s) participation in, or presence at, read the above-referenced activity at any time. This release from liability also releases the RELEASEES from any liability or claims related weapon section and agree to the use of photographs or videos, for publicity purposes related to the Abacoa clubs/activities, of the undersigned participant (and any minor child the undersigned is signing this document on behalf of)above listed statement. This assumption of risks and release from liability shall be binding on my (and said minor’s child’s) heirs and assigns, and shall operate to bar all claims against the RELEASEES regardless of whether liability may arise out of negligence or carelessness of the RELEASEES. If you are interested in an Individual Plot, contact Xxxxxx Xxxxxxx xxxxxxxxxxx@xxxxx.xxx for information and availability. NameInitial: AddressSignature: Preferred Phone: E-mail: (*For Full Size Renewal ONLY. ½ Sized Plot: $45 Table Top Bed: $35 Abacoa Community Garden c/o Abacoa POA, Inc. 0000 Xxxxxxxxxx Xxxx. Suite 102 Jupiter, FL 33458Date:
Appears in 1 contract
Samples: Liability Waiver
Liability Waiver. I UNDERSTAND THAT THERE MAY BE RISKS ASSOCIATED WITH THE ABACOA COMMUNITY GARDENThe tools in our collection are for the use of The Tool Library members. By signing belowOut of respect for future users, I hereby represent please clean any tools you borrow before returning them and report any damage to The Tool Library immediately. Though borrowers are responsible for damage that they have caused, we promise not to be angry. If you feel compelled to return them in better condition than when you borrowed them, that would be highly appreciated. I, (print name), state that I am familiar with capable and assume experienced in using the tools I am borrowing, and that I will use the tools I am borrowing in a proper manner. I, (print name), do hereby for myself, on behalf of my successors and assigns, in consideration of being permitted to borrow tools, waive any and all risks claims against The Tool Library, its officers, agents, and employees for any injury or injuries of any nature that I may suffer or incur in the use of the tools that I am borrowing from The Tool Library. I, (print name), hereby for myself, on behalf of my successors and assigns, in consideration of being permitted to borrow tools, agree to release and indemnify and hold harmless The Tool Library, its officers, agents, and employees from any and all liability, loss, claims, and demands, actions or causes of action for the death or injury to any persons and for any property damage suffered or incurred by any person which arises or may arise or be occasioned in any way associated with my participation (or from the participation use of my minor child) in the above-referenced club/activity which has been organizedtools I am borrowing from The Tool Library. I am aware that The Tool Library, sponsored, or endorsed in any manner by Abacoa Property Owners’ Assembly, Inc. (the “APOA”), and I hereby release the APOA and Renewal Church, their employees, licensees, members, agentsits partners, directors, officers, managersmembers, and management company as well as employees claim no expertise and make no representation concerning the fitness of any member tool for any particular use. I affirm that the above information is current, true and correct and may be subject to verification. I further state that I have read and fully understand the rules and regulations of the garden (collectively the “RELEASEES”) from The Tool Library and I understand that failure to comply with any of these rules may result in revocation of my borrowing privileges and/or legal action against me. I have read and signed a Waiver and Indemnification form, relinquishing any and all claims for damages for personal injuryThe Tool Library, deathits officers, or property damage of any kind which may hereafter accrue to me (or my minor child, if I have signed below for a minor) or any person, as a result of, or in any way related to, my (or said minor’s child’s) participation in, or presence at, the above-referenced activity at any time. This release from liability also releases the RELEASEES from any liability or claims related to the use of photographs or videos, for publicity purposes related to the Abacoa clubs/activities, of the undersigned participant (and any minor child the undersigned is signing this document on behalf of). This assumption of risks and release from liability shall be binding on my (and said minor’s child’s) heirs and assignsagents, and shall operate employees. Signature Date: / / Thank you for joining The Tool Library. Please complete the information below and return this sheet to bar all claims against the RELEASEES regardless of whether liability may arise out of negligence or carelessness of the RELEASEESThe Tool Library. If you are interested in an Individual PlotUpon approval, contact Xxxxxx Xxxxxxx xxxxxxxxxxx@xxxxx.xxx for information and availabilityyour membership will be activated. Welcome! Name: Address: Preferred PhoneCity: EState: Zip: Phone #: Email Address: Are you at least 18 years of age? YES NO Date of Birth: / / *Proof of driver’s license may be requested in order to obtain membership I HAVE READ AND AGREE TO ABIDE BY THE TOOL LIBRARY’S USER POLICY. Signature Date of Agreement: / / Authorizer Name: What is your race/ethnicity? (In-maildepth definitions on back) Hispanic or Latino Non-Hispanic or Latino Racial Categories Select All That Apply American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Other: Income Category (*For Full Size Renewal ONLY. ½ Sized PlotSee “HUD INCOME GUIDELINES FOR FY 2013-14/ PROJECT YEAR 39”) o Extremely Low o Low o Moderate o Above Moderate Residential Location (In-depth definitions on back) o West Bloomington o Bloomington o Normal Please circle one: $45 Table Top Bed: $35 Abacoa Community Garden cHOMEOWNER or RENTER Here you can find in-depth explanations of the race/o Abacoa POA, Inc. 0000 Xxxxxxxxxx Xxxx. Suite 102 Jupiter, FL 33458ethnicity categories
Appears in 1 contract