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402-575-5525
606 Regency Pkwy, Omaha, NE 68114
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Swim
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Parent and Swimmer Information
Parent Name
*
First
Last
Phone
*
Email
*
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Swimmer Name
*
First
Last
Age at the time of lesson
*
Date Of Birth
*
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Waivers
Swimming Lesson Waiver
*
Swimming, like all athletic activities, involves elements of risk to participants, and can be a challenge for some persons. In consideration of being allowed to participate in swim lessons at Regency, the participants and their parent(s)/guardian(s), for themselves and their families, heirs, administrators, estates and executors, voluntarily agree to assume all inherent risks incidental to swimming lessons, and agree that Regency Homeowner’s Association, its members/owners, employees, agents, sponsors, volunteers, instructors, the owners of the host site(s), and their successors and/or assigns, are not liable for, and I/we hereby release from, any and all claims for costs, damages, death and/or injury to the fullest extent allowed by law resulting from those swimming lesson programs/activities, even if arising from ordinary negligence of Regency Homeowner’s Association. Participants and/or spectators agree to observe all rules and of the host site(s) where/when the swim lessons are held. Permission is given to utilize your video or photo image or likeness for promotional purposes when obtained incidental to any event. Medical Certification & Release: I certify that the Participant is in good physical health and has no medical condition(s) that would prevent full participation in the outlined activities and programs. In the event of any medical emergencies, I authorize RHA to take whatever actions it deems necessary (including transport to medical service providers), and I agree to assume fully responsibility for all costs associated therewith. I have read, fully understand (including that I am giving up legal rights/remedies which may be available to me), and voluntarily agree to each of the above items.
I have read and agree to the release.
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