SHARON ELEMENTARY ANNUAL POOL PARTY PAYMENT FORM

ASSUMPTION OF RISK AND WAIVER OF LIABILITY

DISCLAIMER: FOXCROFT EAST RACQUET AND SWIM CLUB ("FXE") IS NOT RESPONSIBLE
FOR ANY INJURY INCLUDING DEATH OR LOSS OF PROPERTY TO ANY PERSON SUFFERED
WHILE PARTICIPATING IN THE USE OF FXE Premises FOR ANY REASON INCLUDING, BUT
NOT LIMITED TO, THE UTILIZATION OF ANY EQUIPMENT, INCLUDING THE POOL, OR THE
PLAYING, PRACTICING OR SPECTATING OF ANY ACTIVITY OCCURRING IN OR AROUND
THE FXE Premises.

1. NOTICE OF RISK OF USE OF FXE PREMISES. I AM AWARE THAT THE USE
OF THE FXE PREMISES AND PARTICIPATION IN AN EVENT WHICH INVOLVES THE USE OF
THE FXE PREMISES INVOLVES RISKS, INCLUDING BUT NOT LIMITED TO INJURY, DEATH,
THEFT, AND OTHER RISKS ASSOCIATED WITH MY AND OTHERS’ SAFETY AND
PROPERTY. I acknowledge that FXE cannot insure or guaranty that the participants, equipment, FXE
Premises and/or activities will be free of hazards, accidents and/or injuries. I am voluntarily using the
FXE Premises and participating in events that involve the use of the FXE Premises with the full
understanding of these risks and knowledge of potential dangers involved with the use of the FXE
Premises, and I agree to accept and assume all risks.

2. ASSUMPTION OF FULL RESPONSIBILITY FOR AND RISK OF BODILY
INJURY, DEATH OR PROPERTY DAMAGE. I hereby assume full responsibility for all the
foregoing risks, including the risk of bodily injury and death to me and other individuals and property
damage due to use of the FXE Premises and participation in an event involving the use of the FXE
Premises, or arising from my involvement in any activities within the FXE Premises or my receiving
instruction from FXE agents or employees relating to those activities.

3. RELEASES, WAIVERS, AND DISCHARGES. I HEREBY RELEASE AND
FOREVER DISCHARGE FXE and its members, employees, lifeguards, owners, shareholders, officers,
directors, agents, successors, and assigns (“Releasees”), from and against ANY AND ALL LIABILITY
to me, my personal representatives, assign, heirs and next of kin, for any and all loss, injury or damage,
and any and all claims, demands, causes of action and suits by reason of, relating to, resulting from or in
connection with the use of the FXE Premises and participation in any event involving the use of the FXE
Premises, or arising from my involvement in any activities within the FXE Premises and my receiving
instruction from FXE agents or employees relating to those activities.

I HAVE READ AND HEREBY VOLUNTARILY SIGNED THIS ASSUMPTION OF RISK
AND WAIVER OF LIABILITY AND FULLY UNDERSTAND THAT I HAVE KNOWINGLY
GIVEN UP LEGAL RIGHTS BY VOLUNTARILY SIGNING IT and further agree that no oral
representations, statements or inducements apart from the foregoing written agreement have been made.