Informed Consent Agreement & Waiver of Liability
As a condition to, and in consideration of, my use of the pool, pool area, tennis courts, tennis area, fields and shower/bathroom facilities included therewith (collectively, the “Facility”) located in on the grounds having a street address of 2463 Buckelew Dr, Falls Church, VA 22046, I have agreed to execute this Informed Consent Agreement and Waiver of Liability (this “Release”) for the benefit of Poplar Heights Recreation Association, and each of their respective successors and assigns, and officers, directors, shareholders, partners, employees, and agents (collectively, “Owner Parties”). I hereby certify, covenant and agree as follows:
- I am 18 years of age or older, in good physical condition and can use the Facility. I am not aware that I have any medical condition or symptoms that would prevent me from participating in or increase my risk of health problems arising out of, activities or utilization of the Facility. I have recently had a physical examination and have been given my physician’s permission to use the Facility.
- I understand that parts of the Facility are or may be unmanned and unsupervised during its hours of operation. I understand that Owner and Owner Parties do not have any expertise in the management or operation of the Facility, including without limitation determining the effect of any specific activity, and that no representations or warranties, express or implied, have been made by Owner or any Owner Parties with respect to the condition of the Facility or any of the equipment or facilities located therein, and any and all such representations and warranties are disclaimed by Owner and Owner Parties to maximum extent permitted by law. I also understand that neither Owner, nor any Owner Parties have any expertise in diagnosing, examining or treating medical conditions of any kind or in determining the effect of any specific exercise or activity on such medical condition, and no representations to the contrary have been made to me. Notwithstanding the foregoing, I acknowledge that Owner or any Owner Parties may, but shall not be obligated to, administer first aid to me in the event that Owner and/or any Owner Parties shall deem an emergency to exist, and I hereby grant my permission to the administering of first aid in such circumstances and agree that I will be solely responsible for any medical costs and expenses which may arise as a result thereof.
- I understand that my use of the Facility, including any equipment and/or the facilities located therein, presents the risk of physical injury or death, and/or of loss of or damage to my personal property. I ASSUME THIS RISK AND AGREE THAT MY USE THE FACILITY SHALL, AT ALL TIMES, BE AT MY OWN RISK. I, ON BEHALF OF MYSELF, MY HEIRS AND PERSONAL REPRESENTATIVES, HEREBY KNOWINGLY AND VOLUNTARILY AGREE TO WAIVE AND RELEASE OWNER AND ALL OWNER PARTIES FROM ANY LIABILITY, LOSS, COST, DAMAGE, EXPENSE, CLAIM OR SUIT WHATSOEVER (COLLECTIVELY, “CLAIMS”) FOR ANY AND ALL INJURY, LOSS, ILLNESS, HARM, COST, EXPENSE, CLAIM, SUIT, OR DAMAGE RESULTING FROM OR RELATED TO MY USE OF THE FACILITY OR THE EQUIPMENT AND Facilities located therein. I SPECIFICALLY UNDERSTAND THAT I AM WAIVING AND RELEASING ANY CLAIMS I MAY HAVE PRESENTLY OR IN THE FUTURE FOR THE NEGLIGENT ACTS OR OTHER CONDUCT BY oWNER OR ANY OWNER PARTIES. i FURTHER AGREE TO AGREE TO INDEMNIFY AND HOLD HARMLESS OWNER AND ALL OWNER PARTIES FROM AND AGAINST ANY AND ALL THIRD-PARTY CLAIMS arising as a result of my use of the facility. THE FOREGOING waiver and RELEASE INCLUDES, WITHOUT LIMITATION, ANY AND ALL CLAIMS FOR ANY AND ALL INJURY, LOSS, ILLNESS, HARM, COST, EXPENSE, CLAIM, SUIT, OR DAMAGE RESULTING FROM OR RELATED TO THE PRESENCE OF ANY BACTERIA, VIRUS OR HARMFUL CONTAMINANTS AT THE FACILITY, AND THE CONTRACTION OF ANY DISEASE, ILLNESS OR OTHER HEALTH CONDITION IN CONNECTION THEREWITH, INCLUDING WITHOUT LIMITATION, THE NOVEL CORONAVIRUS DISEASE COMMONLY KNOWN AS COVID-19.
- I have received and read a copy of the current rules and regulations governing the use and hours of operation of the Facility and the equipment and facilities located therein, a copy of which is attached hereto, and I shall fully comply with all such rules and regulations, as they may be amended from time to time.
- If any portion of this Release shall be deemed by a court of competent jurisdiction to be invalid, then the remainder of this Release shall remain in full force and effect and the invalid portion shall be enforceable to the extent permitted by law.
- I agree to abide by the PHRA Operating Rules
I UNDERSTAND THAT THIS IS AN IMPORTANT LEGAL DOCUMENT. I HAVE CAREFULLY READ THIS DOCUMENT IN ITS ENTIRETY BEFORE SIGNING BELOW AND FULLY UNDERSTAND AND AGREE TO ITS CONTENTS.