Take Me To The Water Aquatics, Inc.
Waiver / Release of Liability

______(Adult), being over the age of 18 years, and/or being the parent/legal guardian of ______(Child), has either enrolled or has enrolled a minor (known as “Enrollee”) to participate in aquatic activities offered by Take Me To The Water Aquatics, Inc. d/b/a Take Me To The Water, at a facility (known as “Center”) used, leased or licensed to Take Me To The Water. I hereby agree and state as follows:

  1. I recognize there are certain risks involved in swimming activities including bodily injury and death.
  2. I hereby waive, release and forever discharge Take Me To The Water and Center, their shareholders, owners, members, directors, officers, agents and employees (the “Released Parties”) from any and all actions, suits, demands, claims, damages, and causes of action of any type or kind whatsoever arising out of or caused by Enrollee’s participation in any aquatic activities at the Center.
  3. I hereby agree to indemnify, defend, and hold harmless the Released Parties from and against any and all actions, costs, suits, demands, claims, damages, losses and liabilities (including reasonable attorney’s fees) of any type or kind whatsoever arising out of or caused by Enrollee’s participation in aquatic activities at the Center.
  4. I hereby authorize any representative of Take Me To The Water to arrange to treat Enrollee for injury in any medical emergency during participation in aquatic activities at the Center. Further, I agree to pay all costs incurred for medical care and transportation for Enrollee, as the case may be.
  5. I represent that Enrollee has no known medical/health problems except as specifically noted below.
  6. I have carefully read the terms of this waiver/liability release and sign it with full knowledge of its contents and significance.

Date: / Signature:
Print Name:
Address:
Telephone:
Email:

Special medical conditions and/or medications taken: ______

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