CDD Waiver & Release
Pursuant to Florida Statute 744.301:
NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN
READ
THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD
ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN
IF THE DURBIN CROSSING COMMUNITY DEVELOPMENT DISTRICT USES REASONABLE CARE
IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY
INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN
DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY
SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO
RECOVER FROM THE DURBIN CROSSING COMMUNITY DEVELOPMENT DISTRICT IN A
LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY
DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU
HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND DURBIN CROSSING COMMUNITY
DEVELOPMENT DISTRICT HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF
YOU DO NOT SIGN THIS FORM.
In
consideration of the below-named individual’s (“Participant”) participation in
the swim program operated by the Durbin Crossing
Dolphins Swim Team, Inc.(“Program”), I,
__________________________________, on behalf of my minor child, acknowledge
and understand that neither the Program nor the Program instructor(s)
(“Instructor”) are affiliated in any way with the Durbin Crossing Community
Development District (“District”) and that the District does not endorse any
such third parties, and that the District makes no representations concerning
the qualifications or ability of any such third parties to conduct, teach, or
lead the Program. On behalf of Participant, I acknowledge that Participant
willfully and voluntarily assumes and accepts sole responsibility for all risks
related to participation in the Program, including, but not limited to, the
risks mentioned above, damage to, loss or theft of real or personal property,
or other loss or harm of any kind or nature.
I acknowledge on behalf of Participant that he or she is voluntarily
participating in the Program with knowledge of the dangers involved, and
Participant agrees to assume and accept sole responsibility for Participant’s
safety and for any and all harm that may occur.
I
acknowledge on behalf of Participant that the District recommends that the
Participant consult a physician prior to engaging in the Program. I further
acknowledge that Participant has either had a physical examination and been
given a physician’s approval to participate in the activities or has elected to
participate in the activities without the approval of a doctor and hereby
assumes all risk and responsibility for participation in the Program. I hereby
certify that the Participant is physically and mentally capable of
participating in the Program and that the Participant is not under any kind of
medical treatment nor has any mental or physical condition that would prevent
Participant from participating in the Program.
I
also acknowledge that attending any event, activity, or gathering, including the
Program may increase my risk of exposure to the COVID-19 virus. I acknowledge
the contagious nature of COVID-19 and voluntarily assume the risks, including
but not limited to that the Participant may be exposed to or infected by
COVID-19 and that such exposure or infection may result in personal injury,
illness, permanent disability, and death to myself or those with whom the
Participant comes into close contact. I accept full responsibility for all
medical expenses for any injuries, illness, or exposure the Participant might
receive by reason of participation in the Program, whether related to COVID-19
or otherwise.
On
behalf of Participant, I hereby indemnify, waive, release, hold harmless, and
forever discharge the District and its present, former and future Supervisors,
agents, officers, employees and staff, and its employees, agents and staff, and
Vesta Property Services, Inc., and its employees and agents (collectively, the
“Indemnitees”), for any and all
liability, claims, lawsuits, actions, suits or demands, whether known or
unknown, in law or equity, by any individual of any age, or any corporation or
other entity, for any and all loss, injury, sickness, damage, theft, real or
personal property damage, expenses (including attorney’s fees, costs and other
expenses for investigation and defense and in connection with, among other
proceedings, alternative dispute resolution, trial court, and appellate
proceedings), and harm of any kind or nature arising out of, or in connection
with, the participation in the Program. This waiver of liability does not apply to any act of gross
negligence, or intentional, willful or wanton misconduct by the Indemnitees.
However, I agree that nothing herein shall constitute or be construed as a
waiver of the District’s limitations on liability contained in section 768.28,
Florida Statutes.
This
Waiver and Release Agreement is
binding upon myself, my spouse, heirs, executors, administrators, legal
representatives, successors and assigns and the Participant. This Waiver and Release Agreement supersedes
any prior written and/or oral agreements or representation made with respect to
the subject matter contained herein. The provisions of this Waiver and Release Agreement will continue in full force
and effect even after the termination of the Program. The provisions of this Waiver and Release Agreement may be
waived, altered, amended or repealed, in whole or in part, only upon the prior
written consent of the District, and Vesta Property Services, Inc., altogether,
and the party whose signature appears below. Nothing herein shall alter the
Participant’s rights or obligations under the Policies and Fees for the District Amenity Facilities and/or related
documents.
If Participant is a minor child, I certify that I am
the Participant’s parent and/or legal guardian and that I am legally authorized
to sign this Waiver and Release Agreement on behalf of the Participant. Further, in the event that I cannot
be reached, the District
is authorized
to seek emergency treatment, as required, and to transport the Participant to
the appropriate medical facility in the event that urgent/emergency care is
necessary. The medical facility and its medical staff have authorization to
provide any treatment that a physician deems necessary for the well-being of the Participant. Participant shall be responsible for any resulting expenses.
The
District and Vesta Property Services, Inc. are
not responsible for providing such treatment or transportation and I
hereby agree to hold the District, its supervisors, agents, officers and staff
and Vesta Property Services, Inc., harmless for any acts or omissions related
to emergency medical transportation and/or treatment resulting from myself or
my child’s participation in the Program.
I further agree to pay all expenses, including court costs
and attorney fees, incurred by the Indemnitees in investigating and/or
defending a claim or lawsuit resulting from or related to the emergency medical
transportation and/or treatment of the Participant. I am of lawful age and
legally competent to sign this Waiver and Release Agreement on behalf of Participant. I have read and understand the terms of this Waiver and
Release Agreement, and I have willingly signed it as
my own free act.
I am of
lawful age and legally competent to sign this Waiver and Release. I have read and understood the terms of this waiver
and release AND understand that I am giving up substantial LEGAL rights FOR
MYSELF, MY SPOUSE, MY MINOR CHILDREN, HEIRS, EXECUTORS, ADMINISTRATORS, LEGAL
REPRESENTATIVES, SUCCESSORS, AND ASSIGNS. I acknowledge
that I am signing this waiver and release freely and VOLUNTARILY AND intend by
my signature to be a complete and unconditional release of liability AS SET
FORTH HEREIN AND to the greatest extent allowed by law. If
Participant is a minor child, I further certify that I am the Participant’s
parent and/or legal guardian and that I am legally authorized to sign this waiver
and release on behalf of the Participant.
YES, I AGREE.
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Enter your initials to indicate acceptance:
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