Pass Modification Form
  • Pass Modification Form

    Cancellation/Hold
  • Residency
  • Date
     - -
  • Format: (000) 000-0000.
  • Membership Hold

    Please enter both the hold start and end date, once end date passes billing will resume
  • Date Hold Begins
     - -
  • Date Hold Ends
     - -
  • Membership Cancellation

    Memberships must be active for 2 months prior to cancellation
  • Cancellation Date
     - -
  • Refund Option
  • Date
     - -
  •  Fitness Center Waiver and Release

     


    The Skokie Park District is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. The Skokie Park District continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participant's safety. However, participants and parents/guardians of minors registering for this program must recognize that there is an inherent risk of injury when choosing to participate in recreational activities/programs.

    You are solely responsible for determining if you or your minor child/ward are physically fit and/or adequately skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, suffers from an underlining medical condition, takes medication, smokes cigarettes, has a family history of coronary disease, or has recently suffered an illness, injury or impairment, to consult a physician before undertaking any fitness center activity.

    WARNING OF RISK

    Aerobic and other fitness activities such as passive/resistive weight training, use of stair machines, jogging, free weights, and other training devices are intended to challenge and engage the physical, mental and emotional resources of the participant. Despite careful and proper preparation, instruction, medical advice, conditioning, and equipment, there is still a risk of serious injury. All hazards and dangers can not be foreseen. Depending on the particular activity, certain risks, dangers and injuries due to overexertion, improper technique, ignoring safety precautions, failing to follow instructions, slips and falls, unfamiliarity with the equipment and/or exercise, equipment failure, failure in supervision/instruction, premises defects and other risks inherent, to. the particular activity exist. In this regard, it is impossible for the Skokie Park District to guarantee absolute safety.

    WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK

    Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services and vehicle operations, when provided).

    1 recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Skokie Park District, including its officials, agents, volunteers and employees.

    I have read and fully understand the A important information, warning of risk, assumption of risk and waiver and release of all claims. If registering on-line or my on-line or signature shall substitute for and have the same legal effect as an original form signature.

    Release and Hold Harmless Agreement


    Participants 18 years of age or older, and parents of participants under the age of 18, should read this form carefully and be aware that in signing up and participating in this program you will be waiving and releasing all claims for injuries or damages you might personally sustain which might arise out of this program. As a participant in this program (or as a parent of a minor participant), I recognize and acknowledge that there are certain risks of physical injury associated with such participation, and I agree to assume the full risk for any injuries, damages, or loss which I may sustain as a result of participating (or of my minor child's participation) in such program as against the Skokie Park District, its officers, agents, servants, and employees. I do hereby fully release and discharge the Skokie Park District and its officers, agents, servants, and employees from any and all claims from injuries, damages, or loss which I may have or which may accrue to me on account of my participation (or on account of my minor child's participation) in the program. I further agree to indemnify, hold harmless, and defend the Skokie Park District and its officers, agents, servants, and employees from any and all claims resulting from injuries, damages, and losses sustained by me and arising out of, connected with, or in any way associated with the activities of the program, including transportation services when provided (or my minor child's participation in the activities of the program).

    I have read and fully understand this Release and Hold harmless Agreement and any program details provided to me. It is mutually understood that the facsimile registration document (including waiver and release of all claims) shall substitute for and have the same legal effect as the original form.

    Participant Behavior Code of Conduct

    The following behavioral code of conduct will be used as a guideline for Skokie Park District program participants. Participants will:

    ·         Show respect to all other participants, staff and volunteers

    ·         Follow direction from staff and volunteers

    ·         Show respect to equipment, supplies and facilities

    ·         Not use inappropriate, abusive or foul language

    ·         Not show any aggressive behavior (hitting, punching, slapping, kicking, biting, etc.) regardless if the behavior is initiated or in retaliation

    ·         Not show continuous disruptive behavior

    ·         Obey all Skokie Park District rules and regulations

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