Please note that by applying for and accepting a swimming pool membership at the Harleysville Community Center you agree or acknowledge:

  1. to abide by all rules, policies and regulations of the Harleysville Community Center for the use of the pool facilities.
  1. that the use of any pool facility includes some risk of personal injury and such use has an inherent element of risk of injury or personal property damage.
  1. that the Harleysville Community Center staff has the right to enforce rules of conduct and may remove members and guests from the premises for failure to comply with these rules. Members and guests shall not be entitled to receive a refund after such removal.
  1. to provide, if requested, a birth certificate or other proof of age acceptable to the Harleysville Community Center.
  1. to provide, if requested, proof of residency; documents can include the following:

Adults – photo IDs showing address; bills in individual’s name showing address

Children – school photo ID; birth certificate; guardianship papers showing address

Senior Citizen – paperwork from Medicare or Social Security showing address

Harleysville Community Center Pool  

Combined Participation/Registration/COVID-19 Waiver 

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AND CONSENT AGREEMENT 

IN CONSIDERATION of being permitted to participate in any way in the Harleysville Community Center Pool (“Pool”) operations,  including entering upon, using and enjoying the swimming pool, pool facilities, and other amenities (hereinafter  “Activities”), I, for myself, for personal representatives, assigns, heirs, next of kin, listed members on my account, my  minor children or children under my care, and all sponsored guests: 

  1. ACKNOWLEDGE, agree, and represent that I understand the nature of such Activities and that I am qualified,  in good health, and in proper physical condition to participate in such Activities. I further agree and warrant  that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the  Activities. 
  2. FULLY UNDERSTAND THAT: Harleysville Community Center Pool: (a) ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS  BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”), (b) these Risks and  dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the  Activities, the condition in which the Activities takes place, or THE NEGLIGENCE OF THE “RELEASED PARTIES”  NAMED BELOW, (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me  or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL  RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the  minor in the Activities. 
  3. AGREE TO ABIDE by the Harleysville Community Center Pool’s rules for safe use of our pool and facilities including  honoring our rules for familial relationship for registered family members. Further agree to treat our  employees, management and other patrons with dignity and respect while using our facilities. Copy of rules  available upon request. 
  4. FULLY UNDERSTAND THAT the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the  World Health Organization and that COVID-19 is extremely contagious and is believed to spread mainly from  person-to-person contact.  
  5. ACKNOWLEDGE THAT I AM AWARE OF THE COVID-19 PANDEMIC AND RELATED GOVERNMENTAL ORDERS, DIRECTIVES AND GUIDELINES (COLLECTIVELY “DIRECTIVES”), INCLUDING DIRECTIVES FOR FREQUENT HAND  WASHING, THE PROHIBITION ON THE CONGREGATION OF GROUPS OF PEOPLE, SOCIAL DISTANCING AND USE  OF FACE MASKS IN PUBLIC LOCATIONS. I AM AWARE THAT POOL ACTIVITIES ARE OCCURRING IN A PUBLIC  LOCATION DURING THE COVID-19 PANDEMIC AND ARE THEREFORE HAZARDOUS ACTIVITIES. I AM AWARE  THAT I COULD BE EXPOSED, INFECTED, SERIOUSLY INJURED OR EVEN DIE DUE TO COVID-19 OR DUE TO  ACTIVITIES AT THE POOL. I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE  DANGER INVOLVED AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY  DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN. The Harleysville Community Center Pool has put in place preventative measures to reduce the spread of COVID-19; however, the management cannot guarantee  that you or your child(ren) will not be exposed or become infected with COVID-19. Further, attending  Activities at the Pool could increase your risk and your child(ren)’s risk of contracting COVID-19.  
  6. ACKNOWLEDGE that by entering the Pool area, I represent on behalf of myself and my children that we have  no symptoms of COVID-19, are feeling well and that we have not knowingly been exposed to anyone who has  COVID-19.  
  7. ACKNOWLEDGE that by signing this agreement, I am aware of the contagious nature of COVID-19 and  voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending  the Pool and that such exposure or infection may result in personal injury, illness, permanent disability, and death (“COVID-19 Risk” and together with “RISKS” referred to as “ALL RISKS”). I understand that the risk of  becoming exposed to or infected by COVID-19 at the Pool may result from the actions, omissions, or  negligence of myself and others, including, but not limited to, Pool employees, volunteers, and program participants and their families.
  1. VOLUNTARILY AGREE TO ASSUME ALL RISKS and accept sole responsibility for any exposure and/or injury to  my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage,  loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection  with my attendance and my child(ren)’s attendance at the Pool or participation in Pool Activities (“Claims”).  
  2. ON MY BEHALF AND ON BEHALF OF MY CHILDREN, HEREBY RELEASE, COVENANT NOT TO SUE, DISCHARGE,  AND HOLD HARMLESS the Harleysville Community Center Pool, and their respective administrators, officers, directors, managers, boards, departments, employees,  members, volunteers, agents, representatives, other participants, any sponsors, advertisers, tenants of the  premises on which the Activities take place, and the respective heirs, successors and assigns of those listed  (the “Released Parties”) OF AND FROM ALL CLAIMS, INCLUDING ALL LIABILITIES, DEMANDS, ACTIONS,  LOSSES, DAMAGES, COSTS OR EXPENSES OF ANY KIND ARISING OUT OF OR RELATING THERETO ON MY  ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE  “RELEASED PARTIES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS, AND INCLUDING  WHETHER A COVID-19 EXPOSURE AND/OR INFECTION OCCURS BEFORE, DURING OR AFTER PARTICIPATION  IN ANY POOL ACTIVITY AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY,  ASSUMPTION OF RISK, INDEMNITY AND CONSENT AGREEMENT I, or anyone on my behalf, makes a claim  against any of the “RELEASED PARTIES”, I WILL DEFEND, INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF  THE “RELEASED PARTIES” from any litigation expenses, attorney fees, loss, liability, damage, or cost from any  such claim. 
  3. By execution below, I acknowledge and represent (i) that I have read the foregoing, (ii) that I understand it  and sign it voluntarily as my own free act and deed, (iii) that no oral representations, statements, or  inducements, apart from the foregoing written Agreement, have been made, (iv) that I am at least eighteen  (18) years of age and fully competent, and (v) that I execute this Agreement for full, adequate, and complete  consideration fully intending to be bound.  

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP  SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE  OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE  GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE  INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. ACCEPTING  MEMBERSHIP THROUGH ANY MEANS, INCLUDING ON-LINE TRANSACTIONS CONSTITUTES YOUR ACCEPTANCE OF  THESE TERMS FOR MEMBERSHIP.

By submitting this payment form, I certify that I am acting as head of household and agreeing to this membership agreement on behalf of myself, family members and minors under my supervision.