IN CONSIDERATION for being permitted to utilize the facilities, services and programs of the Scottsbluff Family YMCA (“YMCA”) and/or for my children listed above to so participate for any purpose, including, but not limited to, observation or use of facilities or equipment, or participation in any off-site program affiliated with the YMCA. The undersigned, on behalf of himself or herself and such participating children and any personal representatives, heirs and next of kin (hereinafter referred to as the “undersigned”) hereby acknowledges, agrees and represent that he or she has inspected and carefully considered such premises, equipment and facilities and/or the affiliated program and that the undersigned finds and accepts same as being safe and reasonably suited the use or participation by the undersigned and such participating children.
In addition, the undersigned acknowledges that novel coronavirus (“COVID-19”) infections have been confirmed throughout the United States including the states of Nebraska and Wyoming. In accordance, the most recent guidance and protocols issued by the Centers for Disease Control (CDC), the State of Nebraska Department of Public Health and Panhandle Public Health for slowing the transmission of COVID-19, the undersigned hereby agrees, represents and warrants that neither the undersigned nor such participating children will utilize the facilities, services and programs of the YMCA if he or she (i) experiences symptoms of COVID-19, including without limitation, fever, cough or shortness of breath, or (ii) has a suspected or diagnosed / confirmed case of COVID-19. The undersigned agrees to notify the YMCA immediately if he or she believes that any of the foregoing access / use restrictions may apply.
The YMCA has taken certain steps to implement recommended guidance and protocols issued by the Public Health Agencies for slowing the transmission of COVID-19, including, without limitation, the access /use restriction set forth above. The undersigned acknowledges and agrees that the YMCA may revise its procedures at any time based on updated recommended guidance and protocols issued by the Public Health Agencies and further agrees to comply with YMCA’s revised procedures prior to utilizing the facilities, services and programs of the YMCA. The undersigned further acknowledges and agrees that duel to the nature of the facilities, service and programs offered by the YMCA, social distancing of 6 feet per person among children and their caregivers in a childcare setting is not possible. The undersigned fully understands and appreciates both the known and potential dangers of utilizing the facilities, service and programs of the YMCA and acknowledges that use thereof by the undersigned and /or such participating children may, despite the YMCA’s reasonable efforts to mitigate such danger, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability and /or death.
IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE INCLUDING BUT NOT LIMITED TO, OBSERVATION OR USE OF FACILITIES OR EQUIPMENT OR PARTICIPATION IN ANY ON-SITE OR OFF-SITE PROGRAM AFFILIATED WITH THE YMCA, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:
THE UNDERSIGNED ON HIS OR HER BEHALF AND ON BEHALF OF SUCH PARTICIPATING CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the YMCA, it’s directors, officers, employees, volunteers and agents from all liability to the undersigned or such participating children and all personal representatives, assigns, heirs and next of kin of the undersigned or such participating children for any loss or damage and any claim or demands on account of any property damage or an injury to or an illness or death of the undersigned or such participating children (or any person who may contract COVID-19, directly or indirectly from the undersigned or such participating children) whether caused by the negligence active or passive, of the YMCA or otherwise while the undersigned or such participating children are in, upon or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA
THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the YMCA, it’s directors, officers, employees, volunteers and agents and of them, from any loss, liability, damages or costs they may incur, whether caused by the negligence, active or passive, or otherwise while the undersigned or any participating child is in, upon or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA. The undersigned understands and agrees that the YMCA is not required to provide insurance to cover the undersigned or such participating children in the event they suffer illness, injury, death, property loss, theft of damage of any sort upon or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA.
THE UNDERSIGNED further expressly agrees that the foregoing ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State of Nebraska and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
I HAVE CAREFULLY READ AND VOLUNTARILY SIGNED THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL PRESENTATIONS, STATEMENT, OR INDUCEMENT APART FROM THE FOREGOING WRITTTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM THE YMCA IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITH LIMITATION, EXPOSURE TO COVID-19 AT ANY YMCA FACILITY OR PROGRAM AND ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. IF SIGHNING ON BEHALF OF A MINOR: I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN) AND / OR LEGAL WARDS AND I REPRESENT AND WARRANT TO THE YMCA THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).
I have read and understand the terms of this Assumption of Risk, Release and Waiver of Liability and Indemnity Agreement and agree to its terms.