Grandparent Membership Application/ Waiver Form
Mail with payment to SPIRIT OF LIFE 4994 Baker Woods Lane Decatur, IL 62521 217-428-2557
2015 GRANDPARENT
MEMBERSHIP APPLICATION ______________
________________________________________________ (Name on Certificate) Membership #
Address:__________________________________________________________________________________________
City: ___________________________________________________ state: ________ Zip__________________
Please print and fill in the appropriate membership form and rates.
_______One time Membership Fee of $75 (if applicable)
_______ Annual Fee
_______ TOTAL PAID ( )Cash ( ) Check #____ ( )Online ( ) Creditcard
GRANDPARENT MEMBERSHIP:
GRANDMOTHER _______________________________ Cell Phone _______________________________
GRANDFATHER________________________________ Cell Phone________________________________
Grandchildren 18 & under: Age as of June 1st Signature of Legal Guardian
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I HAVE CAREFULLY READ THIS AGREEMENT, THE MEMBERSHIP GUIDELINES, THE RULES AND REGULATIONS AND THE RELEASE AND WAIVER OF LIABILITY AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF, SPIRIT OF LIFE SWIM CLUB AND ITS PARENT COMPANY SPIRIT OF LIFE CHURCH AND SIGN IT OF MY OWN FREE WILL. By signing this Agreement, I acknowledge that family members including spouse, children, grandchildren or other family members, dependents, and any guests are covered by this release.
_________________________________________ (Print) ____________________________________ (Signature)
Release and Waiver of Liability Agreement:
Release and Waiver of Liability Agreement: I AM AWARE THAT THESE ACTIVITIES ARE HAZARDOUS ACTIVITIES AND THAT I COULD BE SERIOUSLY INJURED OR EVEN KILLED. I UNDERSTAND THERE IS AN INHERANT RISK OF DROWING IN A POOL. I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN. As consideration for being permitted to participate in the Activities and the use these facilities, I hereby forever release Spirit of Life Swim Club and Spirit of Life Church and its Directors, Officers, employees, volunteers, agents, contractors, representatives, (collectively “Releases”) from any and all actions, claims, or demands that I, my assignees, heirs, distributes, guardians, children and dependents, next of kin, spouse and legal representatives now have, or may have in the future for injury, death, or property damage, related to (i) my participation in the activities, (ii) the negligence or other acts of the Releases , whether directly connected to these activities or not, and however cause, by any Releases , or (iii) the condition of the facilities or the premises where these Activities occur, whether or not I am participating in the Activities. I also agree that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of any Releases in connection with any of the matters covered by the foregoing release. I also agree to defend, indemnify and hold harmless Spirit of Life Swim Club and Spirit of Life Church from any claims of any nature made whatsoever by any guests I may bring to these facilities. In event the Member breaches the terms of the Agreement, the Member shall pay all costs and expenses including attorney’s fees incurred in defending any claims brought in breach of this agreement. This Agreement embodies the entire Agreement and understanding between the Owner and Member and there are no other agreements, representations, or understandings, oral, or written between parties with respect to the subject matter of the agreement. This agreement shall be binding and inure to the benefit of the parties and their respective heirs, successors, legal representative and permitted assigns. The invalidity of any paragraph or subparagraph of this agreement shall be determined to be unenforceable, such provision shall be determined severable and the Agreement may be enforced with such provision severed or as modified by such court. In the event of a default the Member, the Owner is free to pursue any legal remedies at law or in equity. The Owner shall be entitled to collect reasonable attorney’s fees and costs. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND SPIRIT OF LIFE SWIM CLUB AND ITS PARENT COMPANY SPIRIT OF LIFE CHURCH AND SIGN IT OF MY OWN FREE WILL. By signing this Agreement, I
acknowledge that family members including spouse, children, grandchildren or other family members, dependents, and any guests are covered by this release.