Property Owner Pool Waiver & Consent Form – Tallyn's Reach Authority and Metropolitan District Nos. 2 & 3

TALLYN’S REACH METROPOLITAN DISTRICT PROPERTY OWNER FORM

Property Address *

Address Line 1

Address Line 2

City

State

Zip Code

Out-of-District Address: (If Applicable)

Address Line 1

Address Line 2

City

State

Zip Code

Owner Name *

First

Last

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Home Phone *

Work/Cell Phone:

Email Address *

Second Owner Name *

First

Last

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Telephone

Emergency Contact *

Not immediate Family.

Complete Card Number (found on back of card):

Telephone *

Key-Rite Card:

ADDITIONAL AUTHORIZED USERS

Includes:

Adult Children (18+);
Tenants/Renters;
Regularly Employed Caregivers (Nannies/Babysitters);
Immediate Family (incl. Grandparents/Grandchildren); and/or Others Residing at Your Property Address

Additional Authorized Users Do NOT Include Guests.
Each household is allowed 6 users per day. A household may purchase a punch card costing $10 good for 5 uses.

ALL ADULT ADDITIONAL AUTHORIZED USERS MUST COMPLETE AN AUTHORIZED USER FORM AND BE LISTED ON THIS PROPERTY OWNER FORM IN ORDER TO ACCESS THE RECREATION AMENITIES.

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Authorized User Full Name

Gender

Select Field (Gender-gender)

Gender

Relationship to Owner

EACH PROPERTY OWNER MUST ALSO SIGN A WAIVER AND CONSENT FORM

Individual and Parent/Legal Guardian Waiver of Liability and Release Form (Waiver and Consent Form)

Every person, or a parent/legal guardian of a person under the age of 18, desiring to use or participate in activities on/in/around Tallyn’s Reach Authority (TRA) recreational amenity including, but not limited to swimming facilities, fitness center, and dog park must complete this Waiver of Liability and Release Form.

It is possible that you (or your child/ward) may be injured while participating in recreational activities including, but not limited to swimming, exercising, running and climbing (each a “Recreational Activity” and together the “Recreational Activities”) on/in/around the Facilities or other property owned by TRA, either because of your (or your child/ward’s) own conduct, conduct of others, conduct of TRA, or the condition of the Facilities. You (or your child/ward) may also be photographed using the Facilities and such photographs may be used by TRA in promotional materials. TRA wants to make sure that you understand the potential risk of injury before you decide to participate in Recreational Activities on/in/around Facilities owned by TRA. It is required that you read this Waiver of Liability and Release Form very carefully and make sure you understand it. By signing below, you certify that, in advance of participation in the Recreational Activity identified herein, you have received any and all information that you deem necessary or important in making an informed choice regarding your own or your child/ward’s participation in such Recreational Activity.

You recognize and acknowledge that participation in Recreational Activities, on/in/around Facilities owned or operated by involves TRA risk of serious injury and loss. Such loss and injury may include bodily injury, slipping and falling, cardiovascular stress, drowning, permanent disability or death, damage to personal property (including vehicles), exposure to inclement weather, insect or animal bites and severe social and economic losses, which might result from your action, inaction, the negligence of others, the rules of play, or the condition of the Facility or any equipment used thereon. Further, by signing below, you certify that you understand that these are some, but not all of the risks. There may be other risks and dangers, a complete listing of which is not possible and cannot be anticipated, and that you shall assume all such risks and dangers, whether or not described here, known or unknown.

You further acknowledge that you are legally responsible for your actions, your child/ward’s actions (if applicable), and your guests’ actions (if applicable), including, but not limited to, any damage to private or public property and/or personal injury.

You agree to indemnify and hold TRA, its officers, employees, agents, consultants and representatives, harmless from any claim, liability, damage, loss or injury (including death) which may result from your participation, your child/ward’s participation, or your guests’ participation in any Recreational Activity on/in/around Facilities owned by TRA. This release of liability and indemnity applies equally to losses, damages or injuries caused or alleged to be caused in whole or in part by the negligence of TRA. You further agree to release, waive and discharge, and covenant not to sue TRA , its officers, employees, agents, consultants representatives, and contractors for any and all claims, demands or causes of actions whatsoever arising out of any claim, liability, damage, loss or injury (including death) incurred on or to you or your child/ward as a direct or indirect result of your participation (or your child/ward’s) in any Recreational Activity on property owned or operated by TRA. This release of liability and indemnity applies to you, the undersigned, your child/ward, as well as any of your personal representatives, assigns, heirs and next of kin.

You agree that you have received sufficient information regarding the Recreational Activities to assess the potential degree of risk involved, and the extent of possible injury, understand the activities and potential risks, have carefully read and fully understand the effect of relinquishing the rights that you hereby waive, and voluntarily sign this Waiver of Liability and Release Form.

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User Name *

First

Last

Signature of User/Parent/Guardian *

User Address *

Address Line 1

Address Line 2

City

State

Zip Code

Telephone *

Date of Birth

Today's Date *

TALLYN’S REACH METROPOLITAN DISTRICT MINOR RELEASE FORM

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Name of Parent/Guardian

I hereby affirm that I am the parent or legal guardian of the following minors between the ages of 10 and 17: (Please note each child will need to pass a swim test before he/she will be allowed to swim unaccompanied):

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Full Name of Minor

Age of Minor

and as the parent or legal guardian of the above-listed minor(s), I hereby authorize their use of the following Recreation Amenities of the Tallyn’s Reach Metropolitan District without my presence and without the presence of another parent or legal guardian (check all facilities that are authorized for use by the minor(s)):

Facilities

Pool(s)

I further authorize/do not authorize minor(s) between the ages of 16 and 17 to supervise, chaperone, and monitor other minors in the pool area, without my presence and without the presence of another parent or legal guardian (check yes or no):

Authorization

List name(s) of minor(s) authorized to supervise:

In making such authorizations, I acknowledge and agree any activities engaged in at the indicated facilities by said minor will be wholly unsupervised by a lifeguard or other attendant and shall be at the minor’s sole and unilateral risk. Tallyn’s Reach Metropolitan District shall not be liable for any injuries or damages caused or incurred by said minor, or be subject to any claim, demand, injury or damages whatsoever, irrespective of cause or origin and the negligence of the District’s agents, servants, assigns, or employees, or otherwise.

It is agreed and understood that a minor’s unsupervised use of the above-indicated use of the Recreation Amenities may be revoked at any time by the District Manager in the event that said minor disregards or otherwise violates any District rules, regulations, or policies, or otherwise engages in conduct inappropriate for use of the Recreation Amenities.

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By: (Signature of Parent of Legal Guardian)

Name

Today's Date

Contact Number

Propert Address

Address Line 1

Address Line 2

City

State

Zip Code

TALLYN’S REACH METROPOLITAN DISTRICT ADDITIONAL AUTHORIZED USER FORM

All adult Additional Authorized Users must complete this form AND be listed on a Property Owner Form of an in district resident AND sign a Waiver and Consent Form in order to access the Recreation Amenities.

User Information

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Name *

First

Last

Home Phone

Residence Address

Address Line 1

Address Line 2

City

State

Zip Code

E-mail Address for contact purposes:

Work/Cell Phone

Relationship to Property Owner

(Examples: Tenant/Renter, Nanny, Grandparent/Grandchildren)

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2nd Person Name *

First

Last

Home Phone

Residence Address (copy)

Address Line 1

Address Line 2

City

State

Zip Code

E-mail Address for contact purposes:

Work/Cell Phone

Relationship to Property Owner (copy)

(Examples: Tenant/Renter, Nanny, Grandparent/Grandchildren)

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Emergency Contact

(Not Immediate Family)

Telephone

NOTE: Minors must be accompanied by a Property Owner or another Additional Authorized User unless a Minor Release Form is on file with the District Manager.

MANDATORY INFORMATION ON PROPERTY OWNER AUTHORIZING USE:

Address of Property Owner Authorizing Use: (In-District Address)

Address Line 1

Address Line 2

City

State

Zip Code

Owner Name

First

Last

Owner Home Phone

Work/Cell Phone

EACH ADDITIONAL AUTHORIZED USER MUST ALSO SIGN A WAIVER AND CONSENT FORM

Individual and Parent/Legal Guardian Waiver of Liability and Release Form (Waiver and Consent Form)

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User Name *

First

Last

Signature of User/Parent/Guardian *

User Address *

Address Line 1

Address Line 2

City

State

Zip Code

Telephone *

Date of Birth

Today's Date *