Pool Waiver - Minor | lakegenevarentals

EXHIBIT D

GRANDVIEW POINT – GUEST RENTAL AGREEMENT

Minor Pool Waiver

Pool Waiver and Release of Liability Form

Full Name of Booking Guest

Arrival Date

Departure Date

Minor Participant- Full Name

If you are Registered Guest Complete Section A.

If you are NOT a Registered Guest Complete Section B.

Section A) Full Name of Parent/Guardian Only

Section B) Full Name of Parent/Guardian, Address and Phone # in case of an emergency.

I, the undersigned parent or guardian of the above mentioned minor has my permission to participate in swimming activities at Grandview Point, which are hereinafter referred to as the "activities." I consent and fully understand that my minor's participation in the activities may involve risk of serious injury or death, including losses which may result not only from my minor's own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, the condition of the facilities, equipment, or areas where the event or activity is being conducted.

Release - Minor's Rights:

In consideration of allowing the Minor Participant to participate in the activities, I hereby release and hold harmless the Owner, its heirs and its agent (collectively, the "Released Parties"), of and from, and do discharge and waive, any and all claims, demands, losses, damages, and liabilities that Minor Participant may have or sustain with respect to any and all damage and/or injury, of any type, arising out of his or her participating in the activities. I also agree that if any portion of this waiver is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

I certify that my/minor is in good health and have no physical condition that would prevent participation in this activity. Furthermore, I agree to use my/minor's personal medical insurance as a primary medical coverage payment if accident or injury occurs. I consent to emergency medical treatment in the event such care is required.

Indemnification by Parent/Guardian:

The undersigned parent/guardian further agrees to indemnify, save and hold harmless the Released Parties from any and all claims, demands, losses, damages and liabilities for indemnities, contribution or otherwise with respect to any damage and/or injury, of any type, arising from Minor Participant's participation in the activities. The undersigned also agrees that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by the Releasee and is intended to be as broad and inclusive as is permitted by the laws of the State of Wisconsin and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.