University of Pittsburgh at Johnstown
Zamias Aquatic Center
RELEASE OF LIABILITY
This is a legally-binding release made by
(print full name)
to The University of Pittsburgh at Johnstown.
I/We agree to obey all staff members assigned to direct this program and to follow all rules and safety
procedures established by the American Red Cross and The University of Pittsburgh at Johnstown. I/We certify, that
to the best of my/our knowledge, my and my child’s current physical condition is satisfactory for participation in the
aquatic classes. I and my family are free of any health problems which would endanger my/our participation and
that I will inform the instructor should health conditions change at any time during participation in this program.
I/We fully recognize that there are dangers and risks to which I/we or my children may be exposed by
participating in the classes sponsored by The University of Pittsburgh at Johnstown during the 2019 aquatic classes.
Examples of these dangers and risks include but are not limited to: drowning, spinal injury, fractures, and head
injuries. I/We understand that the University does not require me/us to participate in this activity, but I/we want to
do so, despite the possible dangers and risks and despite this Release.
I/We therefore agree to assume and take on myself/ourselves all of the risks and responsibilities in any way
associated with this activity. In consideration of and return for the services, facilities and other things provided to
me by the University in this activity, I/we HEREBY RELEASE THE UNIVERSITY (and its trustees, employees and agents)
FROM ANY AND ALL LIABILITY, CLAIMS AND ACTIONS THAT MAY ARISE FROM INJURY OR HARM TO ME AND MY
FAMILY, FROM DEATH OR FROM DAMAGE TO MY/OUR PROPERTY, IN CONNECTION WITH THIS ACTIVITY. I/WE UN-
DERSTAND THAT THIS RELEASE COVERS LIABILITY, CLAIMS AND ACTIONS CAUSED ENTIRELY OR IN PART BY ANY ACTS
OR FAILURES TO ACT OF THE UNIVERSITY (or its trustees, employees or agents), INCLUDING BUT NOT LIMITED TO
NEGLIGENCE, MISTAKE OR FAILURE TO SUPERVISE BY THE UNIVERSITY.
I/We recognize that this Release means I/We are giving up, among other things, rights to sue the University
for injuries, damages or losses I/we may incur. I/We also understand that this Release binds my heirs, executors,
administrators and assigns, as well as myself/ourselves.
I/We have read this entire release, I fully understand it and agree to be legally bound by it.
Students Name: ______ READ CAREFULLY BEFORE SIGNING.
* Please remember, "if you have or have had diarrhea in the past two weeks, please do not use the pool".
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