Facilities Use & Liability Waiver

Name *

First

Last

Unit # *

Enter numerals only for your unit/lot #.

Address *

Nassau Grove Street Address

Access Card #1 *

Enter 1st 5 digits on back of access card.

Access Card #2 *

Enter 1st 5 digits on back of access card.

Email *

Phone Number *

Personal Responsibility *

I agree that I am personally responsible for my own, my family members’, guests’ and tenants safety and actions while using the swimming pool and/or all other indoor and outdoor recreational areas, collectively called the Facilities in the Nassau Grove community.

Compliance Agreement *

I, for myself and on behalf of my family members,guests and tenants, agree to comply with all Facilities-related policies, rules, guidelines, signage, and instructions imposed and/or posted by the Nassau Grove Home Owners Association, Inc. (HOA).

Risk Assumption *

I understand, acknowledge, and expressly agree that my family members, guests, tenants, and I will not be supervised while using the Facilities. I further understand, acknowledge, and expressly agree that there is risk of accident, injury, illness due to COVID-19 or other causes, or death from the use of the Facilities, and that said risk is expressly assumed by me, my family members, and guests.

Release, Waiver, Discharge Acknowledgement *

With full awareness and appreciation of the risks involved, for myself and on behalf of my family members, guests, tenants, estate, heirs, executors, administrators, assigns, and personal representatives, I hereby forever release, waive, discharge, and covenant not to sue the Association, its Board members, officers, agents, servants, independent contractors, affiliates, employees, volunteers, successors, and assigns (collectively the “Released Parties”) from any and all liability, claims, demands, actions and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, illness or injury, including death, that may be sustained by me, my family members or guests, caused by or related to COVID-19 and/or caused by or related to other viruses or events of any kind or nature whatsoever, whether caused by the negligence of the Released Parties, any third-party using the Facilities, or otherwise, while participating in any activity while in, on, or around the Facilities and/or while using the Facilities.

Indemnification/Hold Harmless *

I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorneys’ fees) arising either directly or indirectly from or related to any and all claims made by or against any of the Released Parties due to bodily injury, illness, death, loss of use, monetary loss, or any other injury from or related to my, my family members’, guests’, or tenants' use of the Facilities, tools, equipment, or materials, whether caused by the negligence of the Released Parties or otherwise specifically caused by or related to COVID-19 and/or caused by or related to other viruses or events of any kind or nature whatsoever.

Age Acknowledgement *

I am at least eighteen (18) years of age and fully competent; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same.

Waiver In Accordance with DE Law *

I agree that this Waiver of Liability shall be governed by and construed in accordance with Delaware law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Waiver of Liability as a whole.

HOA's Rules Acknowledgement *

I acknowledge receipt and have read and understand the HOA's rules and policies for the Facilities, including but not limited to those related to the usage of the pool and pool area, clubhouse, tennis/pickleball court, and bocce court.

Explanation Acknowledgement *

I agree to explain these rules and policies to family members, guests, and tenants.

Facilities Access Acknowledgement *

I understand that failure to sign and submit this form will result in removal of access to the Facilities.

Name *

By typing your name, you acknowledge that this is the same as your signature on this form.

Email *