PARTICIPANTS: 2. CKRI Waiver and Liability Release Agreement

Registering for Participants 2020-21 - 02/19/2021 12:00 AM - 09/01/2021 12:00 AM Change

WAIVER AND LIABILITY RELEASE AGREEMENT:
Courage Kenny Rehabilitation Institute

I hereby agree, for myself and/or on behalf of my child and/or legal ward, heirs, administrators, personal representatives, assigns, and/or guests, if any, to the following:

That in consideration of CKRI (Courage Kenny Rehabilitation Institute) allowing my use of CKRI facilities and its locations and participation in its activities, under the terms set forth herein, I agree to hold harmless, release and discharge CKRI, its owners, agents, employees, personnel, sponsors, officers, directors, representatives, assigns, members, affiliated organizations, insurers, and others acting on its behalf (hereinafter collectively referred to as “ASSOCIATES”), of and from all claims, demands, causes of action and legal liability, whether the same be known or unknown, anticipated or unanticipated, due to CKRI and/or its ASSOCIATES’ ordinary negligence; and I do further agree that, except in the event of CKRI and/or its ASSOCIATES’ gross negligence and willful and wanton misconduct, I shall not bring any claims, demands, legal actions and causes of action, against CKRI and/or its ASSOCIATES as stated above in this clause, for any economic and/or non-economic losses due to bodily injury, death, property damage sustained by me and/or my minor children and/or legal wards, if any, in relation to the premises and/or operations of CKRI.

That if I engage in any physical activity or use of any CKRI facility on the premises, I agree to do so at my own risk and assume the risk of any and all injury and/or damage while engaging in any physical activity or use of any CKRI facility on the premises. My assumption of risk includes, but is not limited to, my use of any CKRI pediatric, exercise or rehabilitation equipment (mechanical or otherwise), the locker room, sidewalk, parking lot, stairs, pool, whirlpool, sauna, steam room, gymnasium, reception area or any equipment in any CKRI facility. I agree to assume this risk in my participation in any activity, class, program, service, instruction or CKRI sponsored event. I agree that I am VOLUNTARILY participating in CKRI activities and using CKRI facilities and premises and assume all risk of injury, harm, damage, or loss to me and my property that might result, including, without limitation, any loss or theft of any personal property.

In the event of illness or injury to my child, I authorize any official representative of CKRI to administer and/or secure medical treatment as deemed necessary by said representative.

This Agreement shall be governed by the laws of the State of Minnesota. If any of its provisions are held to be invalid or unenforceable by a court of competent jurisdiction, such holding shall not invalidate any of the other provisions of this Agreement, it being intended that the provisions of this Agreement are severable. I attest that I am fit and prepared to use CKRI facilities and participate in CKRI activities.

CORONAVIRUS / COVID-19 WARNING. Coronavirus, COVID-19 is a contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing and wearing a mask as ways to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in or accessing CKRI’s programs or facilities could increase the risk of contracting COVID-19.              

CKRI in no way warrants that COVID-19 infection will not occur through participation at CKRI or the accessing of CKRI’s facilities.             

I agree, represent, and warrant that I will not visit or utilize CKRI facilities or services if I (i) experience symptoms of COVID-19, including, without limitation, fever (over 100 degrees F), cough, shortness of breath, headache, diarrhea, loss of smell or taste, or (ii) have a suspected or diagnosed/confirmed case of COVID-19. I agree to notify CKRI immediately if I believe that any of the foregoing access/use restrictions may apply. I acknowledge and assume both the known and potential dangers of utilizing CKRI facilities and services and acknowledge that use of them may, despite CKRI’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death.

ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY AND EXPRESS ASSUMPTION OF RISK. I AM AWARE AND AGREE THAT BY SIGNING THIS WAIVER AND RELEASE, I AM GIVING UP MY RIGHT TO BRING LEGAL ACTION OR ASSERT A CLAIM AGAINST CKRI FOR ITS NEGLIGENCE OR FOR ANY DEFECTIVE PRODUCT ON ITS PREMISES. I HAVE READ AND VOLUNTARILY SIGNED THE WAIVER AND RELEASE AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN  MADE.

Printed Name of Consumer: _____________________________________________________________________________________________________________

Signature of Consumer: _________________________________________________________________________________________________________________

or Parent/Legal Guardian: _______________________________________________________________________ Date: __________________________________

 

I understand that this Agreement also waives and releases CKRI liability for negligence causing any injury to my child and/or legal ward, heirs, administrators, personal representatives, assigns, and/or guests, if any. I attest that they are fit and prepared to utilize CKRI facilities and participate in CKRI activities.

Printed Name(s) of Minor(s) _____________________________________________________________________________________________________________

Printed Name of Parent/Legal Guardian: _________________________________________________________________________________________________

Signature of Parent/Legal Guardian: _____________________________________________________________ Date: __________________________________

 

Who will be participating?

Adult  Adult and Children  Children

Parent / Guardian Information

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.