General Membership and Program Participation Waiver and Agreement

Informed Consent and release of Liability: I certify that I/ my child am/is able to participate fully in the program unless otherwise stated in writing to the YMCA. In case of voluntary withdrawal, I understand that there will be no refund of fee for the period concerned. In consideration of being allowed to participate in the activities and programs of the YMCA (the “YMCA Programs”) and to use the facilities, equipment, and machinery of the YMCA (the “YMCA’s Facilities and Equipment”).

I/We do hereby waive, release and forever discharge, and indemnify and hold harmless the YMCA and its officers, agents, employees, representatives, and all others from any and all responsibility or liability for injuries or damages, except those caused by the negligent act or omission of any of the foregoing persons or entities, arising out of, resulting from or in connection with my/our use of the YMCA’s Facilities and Equipment or my/our participation in any YMCA programs.

I/We understand that participation in the YMCA Programs and the use of the YMCA’s Facilities and Equipment is potentially hazardous. I/We also understand that fitness activities involve a risk of injury and even death and that I/We am/are voluntarily participating in the YMCA Programs and using the YMCA’s Facilities and Equipment with knowledge of the dangers involved. I/We hereby agree to expressly assume and accept any and all risks of injury or death.

I/We understand that the YMCA’s Facilities and Equipment and YMCA Programs may not be advisable for certain individuals, including but not limited to elderly persons, pregnant women, persons suffering from heart disease, diabetes, high or low blood pressure and other conditions and illnesses, and persons taking medication. I/We hereby acknowledge that I/We have been advised to seek advice from a physician regarding my/our participation in YMCA Programs or in the use of the YMCA’s Facilities and Equipment. I/We also acknowledge that it has been recommended that I/We have a yearly or more frequent physical examination and consultation with my/our physician as to my/our participation in YMCA Programs and my/our use of the YMCA’s Facilities and Equipment. I/We acknowledge that I/We have either had a physical examination and have been given my/our physician’s permission to participate, or that I/We have decided to participate in YMCA Programs and/or use the YMCA’s Facilities and Equipment without the approval of my/our physician and do hereby assume all responsibility for my participation in the YMCA Programs and my/our use of the YMCA’s Facilities and Equipment.

Photo / Video / Audio Release - As part of the overall YMCA program, participants occasionally are photographed / videotaped and have work displayed by the YMCA staff. You hereby grant permission and approval that you or your child may be photographed or videotaped by YMCA staff, and also that the participant’s likeness, name, performance, artwork or written work may be used by the YMCA in any YMCA publications, materials, advertisements, website, and programs. The Frederick YMCA permits individuals to use photographic devices during program instruction with certain stipulations on how and where they can be used. A procedure outlining the parameters of this is posted in most program areas and a copy will be made available to individuals that request it. It is required that an individual that uses photographic devices adhere to this procedure. For your safety and security, the YMCA may be monitoring certain areas by video surveillance.

Medical Care Release - I authorize the YMCA to provide medical care and seek advanced medical care for myself or my child should the need arise. I also authorize the YMCA to arrange for transport of myself or my child for the purpose of providing medical care, if necessary, in the discretion of the YMCA or medical personnel.

Transporting for Programs - I understand that some programs involve field trips with travel from the YMCA facility and I give permission to the YMCA to transport me/my child via YMCA vehicle and indemnify and hold harmless the YMCA, its officers, agents, representatives, and employees from any claim for damage or injury to person or property arising out of such transport, except as caused by the gross negligence of the YMCA, its representative, agents or employees.

Membership Policies Waiver - I understand that membership to the Y is a privilege and may be revoked for conduct unbecoming a member as stated in the rules of the facility or at the discretion of the director. I further understand that membership dues are not refundable. It is my understanding that if I wish to terminate my membership in any way, I must give the Y a 30-day written notice from my original draft date.

Release of Child - I authorize my child to sign themselves in and out of said program. I release the YMCA from any liability and responsibility for the child once they have signed out of the program and before they have signed in the program. If not agreed upon, the parent needs to bring the child into said program and sign the child in and pick up the child and sign them out of the program

Changes in status - Participants/parents/guardians are responsible for informing the YMCA of any changes that may affect any of the aforementioned items in this agreement.