Owner Name 1 Owner Name 2 Owner Address MEADOW SWIM & TENBIS CLUB WAIVER OF LIABILITY AND ASSUMPTION OF RISK By checking this box we agree to the Meadow Swim and Tennis Club’s Waiver of Liability and Assumption of risk. In consideration of being permitted to use the Club facilities and participate with the Swim Team, Tennis Team, and any other club programs and/or events, I hereby release, on behalf of myself, my family, my heirs and my assigns, the Club, its employees, agents and sponsors, from liability for injury, death, or loss suffered by me, or my minor children, while using the facilities, or in transit to and from events/matches or in engaging in any activities incidental thereto, wherever, whenever, or however the same may occur, which result from the ordinary negligence of the Club, its employees or agents. Primary Email Secondary Email Home Phone Number Owner 1 Cell Number Owner 1 Work Number Owner 2 Cell Number Owner 2 Work Number Name of Child 1 Birthdate of Child 1 Enter birthdate of Child 1 (MM/DD/YYYY) Name of Child 2 Birthdate of Child 2 Enter birthdate of Child 2 (MM/DD/YYYY) Name of Child 3 Birthdate of Child 3 Enter birthdate of Child 3 (MM/DD/YYYY)