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ADULT Program Participant Waiver

As a member would you like to use the facilities and participate in programs at the Riverbrook Regional YMCA?

Every adult must complete a separate form and acknowledge acceptance of this waiver by submitting below.   

A waiver must also be completed for all children.
Please click here for the CHILD (Minor) Program Participant Waiver>       Thank you.

    ADULT Participant Waiver, Release, Indemnification of All Claims & Covenant Not to Sue

    NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in entirety. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any personal injury or property damage however caused arising out of your participation in Riverbrook Regional YMCA Programs, now or at any time in the future.
    Acknowledgment of Risk

    I hereby acknowledge and agree that participation in any activities comes with inherent risks. I have full knowledge and understanding of the inherent risks associated with Y programs participation, including but in no way limited to: (1) slips, trips, and falls, (2) aquatic injuries, (3) athletic injuries, and (4) illness, including exposure to and infection with viruses or bacteria. I further acknowledge that the preceding list is not inclusive of all possible risks associated with Y programs participation and that said list in no way limits the operation of this Agreement.

    Coronavirus / COVID-19 Warning & Disclaimer
    Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a mean to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in Riverbrook Regional YMCA programs or accessing Riverbrook Regional YMCA facilities could increase the risk of contracting COVID-19. The Riverbrook Regional YMCA in no way warrants that COVID-19 infection will not occur through participation in Riverbrook Regional YMCA programs or accessing the Riverbrook Regional YMCA facilities.

    Waiver, Release, Indemnification & Covenant Not to Sue
    In consideration of my participation in Riverbrook Regional YMCA programs, I, the participant, agree to release and on behalf of myself, my heirs, representatives, executors, administrators, and assigns, HEREBY DO RELEASE the Riverbrook Regional YMCA, its officers, directors, employees, volunteers, agents, representatives and insurers (“Releasees”) from any causes of action, claims, or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I, my heirs, representatives, executors, administrators and assigns may have, now or in the future, against the Riverbrook Regional YMCA on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to the use of the Riverbrook Regional YMCA facilities/equipment or participation in the Riverbrook Regional YMCA programs whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of Releasees.

    In consideration of my participation in Y programs, I, the undersigned participant, agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of or in any way related to my Riverbrook Regional YMCA programs participation.

    I hereby certify that I have full knowledge of the nature and extent of the risks inherent in the Riverbrook Regional YMCA programs participation and that I am voluntarily assuming said risks. I understand that I will be solely responsible for any loss or damage, including personal injury, property damage, or death, I sustain while participating in Riverbrook Regional YMCA programs and that by signing and accepting this agreement I HEREBY RELEASE Releasees from all liability for such loss, damage, or death. I further certify that I am in good health and that I have no conditions or impairments which would preclude my safe participation in Y programs.

    I further certify that I am of lawful age and otherwise legally competent to sign this agreement. I further understand that the terms of this agreement are legally binding and certify that I am signing and accepting this agreement, after having carefully read it, of my own free will.