Taste of Summer 2017
Registration Form

Cell

REQUEST FOR ADMISSION OF CHILDREN I hereby request that Rollingwood Athletic Club/MKD Health & Tennis admit onto its premises under the supervision of the undersigned Sponsoring Agent each of the following minor children (“Children”) of the undersigned Parent or Legal Guardian:

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ACKNOWLEDGEMENT AND ASSUMPTION OF RISK. I understand and agree that there are risks of injury to the Children, whether caused by the Children or someone else, in their use of or presence on Rollingwood Athletic Club premises. I understand and agree that these risks of injury include, but are not limited to, slips, trips, falls, collisions, thefts, equipment failure, or other such accidents or incidents that may result in injury, harm or damage, including but not limited to economic, property, emotional, mental, physical or any other type of damage, including but not limited to sprains, torn muscles or ligaments, broken bones, strokes, heart stress, heart attacks, paralysis, disfigurement, death, or other forms of pain or suffering. On my own behalf, and on behalf of each of the minor Children above, I fully understand, voluntarily accept, and specifically assume these risks of injury to the Children.

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WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT. On my own behalf, and on behalf of each of the minor Children above, I agree to release and discharge from all liability, and waive all claims, demands and actions against Rollingwood Athletic Club and its owners, operators, subsidiaries, affiliates, employees, agents, vendors and volunteers for any and all injuries, harms, or damages sustained by any of the Children in-connection with their use or presence on the premises, or their use of facilities, equipment, services, programs or activities within or outside its centers, resulting or arising from the negligent acts or omissions of Rollingwood Athletic Club, or the negligent acts or omissions of me, any of the Children, other members, guests, visitors or other persons on the premises. I agree to defend, indemnify and Rollingwood Athletic Club/MKD Health & Tennis harmless against any and all claims brought by anyone against, related to such injuries, harms or damages.

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SPONSOR RESPONSIBLE FOR SUPERVISION, MEDICAL DECISIONS WHILE ON PREMISES. Sponsoring Agent will supervise the Children in accordance with Rollingwood Athletic Club policies and will be responsible for their conduct at all times while they are on the premises. In the event the Children are involved in an accident or incident that requires medical attention, I agree that the Sponsoring Agent will be responsible for making all decisions related to medical and survival procedures for the Children, including but not limited to decisions about medical care, the administration of drugs, the performance of life-sustaining procedures, and transportation and admission to any hospital, health center or medical clinic. By signing this Agreement, I certify that I have thoroughly read, fully understand, and voluntarily accept and agree to its terms.

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PHOTO RELEASE WAIVER. I grant to Rollingwood Athletic Club/MKD Health, its representatives and employees the right to take photographs of me and my property in connection with activities occurring at the above stated premises. I authorize Rollingwood Athletic Club/MKD Health, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Rollingwood Athletic Club/MKD Health may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

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Rollingwood Athletic Club

9373 Winding Oak Dr,

Fair Oaks, CA 95628

Phone. 916-988-1727