Program Participant Check-In - Aaron Family Jewish Community Center of Dallas

Program Participant Check-In Form

Complete this form and have the confirmation screen at the end available to show upon entrance to the J.

This confirmation will be REQUIRED for EVERY entrance into any facility at the J. One form per family per entrance.

Today's date *

Time *

:

First and Last Name *

Email

What brings you to the J today? * What brings you to the J today?

Are you checking in a child for a program? *

Yes

No

What is your child's first and last name? *

Waiver, Release, Indemnification of All Claims & Covenant Not to Sue *

PARTICIPANT WAIVER AND RELEASE OF LIABILITY:  READ BEFORE SIGNING
Organization Name:  Jewish Community Center of Dallas, Inc. (the “J”)

In consideration of being allowed to participate in any way in any program, related events and activities at the J or sponsored by the J (“programs”) I on my own behalf and on behalf of any minor children for whom I am responsible appreciate and agree that:

1.   The risk of injury from the activities involved in programs offered by the J may be significant, including the potential for permanent injury or even more serious consequences, and while particular rules, equipment, and personal  discipline may reduce this risk, the risk of serious injury does exist, and;

2.	On my own behalf and on behalf of any minor children for whom I have responsibility, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE J, other than “gross negligence” as defined by Texas law, and those affiliated with the J described in Paragraph 5 or others, and assume full responsibility for my and my minor children’s participation.  If anyone in my family violates any rule or policy of the J or otherwise causes a problem that in the sole discretion of the J CEO endangers the health, safety or welfare of anyone, the CEO may suspend my family’s privilege to be on the J campus and participate in the J’s programs, and;

3. Coronavirus / COVID-19 Warning & Disclaimer: 
Coronavirus a/k/a COVID-19 is an extremely contagious virus which spreads easily through person-to-person or other contact. Federal and state authorities recommend social distancing as a mean to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in programs or activities upon the J premises could increase the risk of contracting COVID-19. The J in no way warrants that COVID-19 infection will not occur through participation in programs or activities upon the J premises.

4.	I willingly agree to comply with the stated and customary terms and conditions for participation.  If I observe any unusual significant hazard during my presence or participation, I will remove myself and my minor children from participation and bring such to the attention of the nearest official immediately.

5. I, for myself and on behalf of my minor children, heirs, assigns, personal representatives and next of kin, HEREBY WAIVE, RELEASE, INDEMNIFY, AND HOLD HARMLESS THE J, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, and, if applicable, owners and lessors (referred to as “Releases”) FOR ALL CLAIMS other than “gross negligence” as defined in Texas law in connection with any conduct regarding any program at the J or any activity sponsored by the J WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

This is to certify that I, as parent/guardian with legal responsibility for the previously named Participant on behalf of the participant do consent and agree to his/her waiver and release as provided above of all the Releasees, and, for myself, my spouse or co-guardian, heirs, assigns, and next of kin, waive, release and agree to indemnify and hold harmless the Releasees from any and all liability, other than “gross negligence” as defined by Texas law, associated with my minor child’s involvement or participation in these programs, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Checking this box means that you accept the terms of this waiver. *

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