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2. Name

   ("the undersigned") do hereby certify and agree as follows:

4. For good and valuable consideration including the privilege of using any Coppell Parks and Recreation Department facility  (the, “Facility”), the Undersigned, do by these presents for myself, my agents, heirs, executors, administrators, and assigns, hereby release and agree to hold harmless the City of Coppell, the Parks and Recreation Department, its officers, officials, agents, contractors, instructors, employees, and any person acting on behalf of the City of Coppell (collectively referred to as the “City”) from any and all actions, causes of action, claims, demands, lawsuits, attorney’s fees, costs, or damages arising from or resulting from any property damage, personal injury, illness, permanent disability, and/or death sustained by me in connection with my use of the Facility.

   I, for myself, my agents, heirs, executors, administrators, and assigns further agree to indemnify, hold and save harmless the City from any and all claims, damages, causes of action of any kind whatsoever, statutory or otherwise, property damage, personal injury, illness, permanent disability, death, lawsuits and judgments, court costs, expenses and reasonable attorney’s fees, and all other expenses resulting directly or indirectly from the actions, omissions and/or activities of me in connection with my use of the Facility. I understand that this release, indemnity and hold harmless agreement shall apply whether or not the claims, damages, causes of action of any kind whatsoever, statutory or otherwise, property damage, personal injury, illness, permanent disability, death, lawsuits, judgments, court costs, attorney’s fees or any other expense arises directly or indirectly from my own negligence, omissions, willful and/or intentional acts.

   In addition, I make the following representations and acknowledgments upon which I intend the City to rely:

   1. I acknowledge the contagious nature of a novel coronavirus designated SARS-CoV2 which causes the disease COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 in connection with my use of the Facility and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my use of the Facility may result from the actions, omissions, or negligence of myself, others, and the City. I also understand that because the Facility is open for use by other individuals, I recognize that I am at higher risk of contracting COVID-19.

   2. I acknowledge that I am personally responsible for my safety and actions while using the Facility and I agree to strictly adhere to all City rules, regulations, and/or policies governing my use of the Facility and will follow any and all lawful directions provided by City employees in connection with the same.   I fully understand and agree that I may be immediately removed from the Facility by the City for failure to fully comply with the terms and conditions of this release, indemnity and hold harmless agreement.

   I certify that I have read the foregoing instrument, that I understand its terms and conditions, that I make this waiver voluntarily and that I have not relied upon any representations made by the City in signing this release. I further certify that I am an adult, in sound mental health, and fully capable of making this waiver of liability.

6. Signature
7. Date
   Date
9. Are you over 18 years of age?

   1. Yes

   1. No
10. Is this a Team or General Activity Waiver?

    1. Team

    1. General Activity
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12. 1. Receive an email copy of this form.
13. Email address

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