SWIMMING POOL WAIVER

By my signature below, I acknowledge that I am aware of, appreciate the character of, and

voluntarily assume the risks involved in participating in all activities associated with swimming in

our public pool.

By my signature below, on behalf of myself, my heirs, next of kin, successors in interest, assigns,

personal representatives, and agents, I hereby:

1. Waive any claim or cause of action against and release from liability the City of De Smet,

its officers, employees, and agents for any liability for injuries to my person or property

resulting from my use of the facility or participation in the activity listed above;

2. Agree to indemnify and hold harmless the City of De Smet, its officers, employees, and

agents for any claims, causes of action, or liability to any other person arising from my

use of the facility or participation in the activity listed above;

3. Consent to receive any medical treatment deemed advisable in the event of injury,

accident or illness during these activities; and

4. Acknowledge that a participant under 18 years of age signing below as a minor child, a

signature is required by the parent or legal guardian of the minor child to participate.

I HAVE READ THIS ASSUMPTION OF RISK, WAIVER OF LIABILITY AND RELEASE AGREEMENT. I

CONSENT TO MEDICAL TREATMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE

GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY

WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY

SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST

EXTENT ALLOWED BY LAW.

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Participant Printed Name _____________________________ Date of Birth __________

Signature __________________________________________________Date________

Address_________________________ City____________________ State__________

Minors: under 18 years of age

Parent/Legal Guardian Printed Name _______________________Relationship __________

Parent or Legal Guardian Signature ______________________________Date__________