Chastain Park Athletic Club

Medical

I hereby give my permission for any supervisor, coach or other team administrator associated with The Chastain Park Athletic Club to seek and give appropriate medical attention to me or any of my family members in the event of accident, injury, or illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment.

I and any participating family members hereby waive, release and forever discharge The Chastain Park Athletic Club and all associated supervisors, coaches or other team administrators from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in The Chastain Park Athletic Club (CPAC) activities, whether or not damages or loss is due to negligence. I hereby acknowledge that I and any participating family members are physically fit and capable of participation in all CPAC teams or related activities.

Liability

By registering with The Chastain Park Athletic Club, I agree to participate and my family members agree to participate in The Chastain Park Athletic Club, and hereby release The Chastain Park Athletic Club, its directors, officers, agents, coaches, volunteers and employees from liability for any injury that might occur to myself (or to my child(ren) and family members) while participating in The Chastain Park Athletic Club program, including but not limited to travel to and from training sessions, swim meets or other scheduled team activities.

I agree to indemnify and hold harmless the above mentioned organizations and/or individuals, their agents and/or employees, against any and all liability for personal injury or illness, including injuries or illnesses resulting in death to me, my child(ren) and/or other family members, or damage to my property, the property to my child(ren) and/or other family members, or both, while I am (or my child(ren) or family members) participating in The Chastain Park Athletic Club programs or related activities.

Media

I hereby grant the Chastain Park Athletic Club the rights to utilize any photographs/images of me or my family/household members obtained while attending or participating in Chastain Park Athletic Club related events, practices, etc and/or at Chastain Park Athletic Club facilities and such images may be reproduced in any type of media for the benefit of the Chastain Park Athletic Club.

2023 Registration Waiver

I hereby verify that the information above is correct, and in consideration of the above named swimmer(s) being allowed to participate in any way in Grown-Up Swimming, related events and activities (the "GUS Programs"), the undersigned acknowledges, appreciates and agrees that:

1. The risk of injury from the activities involved in the GUS Programs is significant, including the potential for permanent disability and even death, and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury to the Swimmer does exist; and

2. On behalf of Swimmer, myself and spouse and our heirs, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF RELEASEES or others, and assume full responsibility for the participation of Swimmer in the GUS Programs; and

3. On behalf of Swimmer, I willingly agree to comply with the states and customary terms and conditions for participation in the GUS Programs. If I observe any unusual significant concern in the readiness of Swimmer for participation or in the GUS Programs, I will remove Swimmer from participation and bring such to the attention of the nearest official immediately, and

4. On behalf of Swimmer, myself, my spouse and our heirs, personal representatives and next of kin, I HEREBY RELEASE GROWN-UP SWIMMING, LLC, its directors, officers, agents and/or employees, other participants, sponsoring agencies, facility owners and lessors, sponsors and advertisers (the "Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to Swimmer's involvement or participation in the GUS Programs, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

5. On behalf of Swimmer, myself, my spouse and our heirs, personal representatives and next of kin, I HEREBY INDEMNIFY AND HOLD HARMLESS ALL THE ABOVE Releasees from any and all liabilities incident to Swimmer's involvement or participation in the GUS Programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

GUS Concussion Awareness

A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by bump, blow, or jolt to the head or body that causes the head and brain to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious.

WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION?

Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days or weeks after the injury. If an athlete reports one or more symptoms of concussion listed below after a bump, blow, or jolt to the head or body, s/he should be kept out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says s/he is symptom-free and it’s OK to return to play.

Did You Know?

• Most concussions occur without loss of consciousness.
• Athletes who have, at any point in their lives, had a concussion have an increased risk for another concussion.
• Children and teens are more likely to get a concussion and take longer to recover than adults.

SIGNS OBSERVED BY COACHING STAFF SYMPTOMS REPORTED BY ATHLETES

• Appears dazed or stunned
• Headache or “pressure” in head Is confused about assignment or position
• Nausea or vomiting
• Forgets an instruction Balance problems or dizziness Is unsure of game, score, or opponent
• Double or blurry vision
• Moves clumsily
• Sensitivity to light Answers questions slowly
• Sensitivity to noise
• Loses consciousness (even briefly)
• Feeling sluggish, hazy, foggy, or groggy
• Shows mood, behavior, or personality changes
• Concentration or memory problems
• Can’t recall events prior to hit or fall
• Confusion
• Can’t recall events after hit or fall Just not “feeling right” or “feeling down”

CONCUSSION DANGER SIGNS

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. An athlete should receive immediate medical attention if after a bump, blow, or jolt to the head or body s/he exhibits any of the following danger signs:

• One pupil larger than the other
• Is drowsy or cannot be awakened
• A headache that not only does not diminish, but gets worse
• Weakness, numbness, or decreased coordination • Repeated vomiting or nausea
• Slurred speech
• Convulsions or seizures
• Cannot recognize people or places
• Becomes increasingly confused, restless, or agitated
• Has unusual behavior
• Loses consciousness (even a brief loss of consciousness should be taken seriously)

WHY SHOULD AN ATHLETE REPORT THEIR SYMPTOMS?

If an athlete has a concussion, his/her brain needs time to heal. While an athlete’s brain is still healing, s/he is much more likely to have another concussion. Repeat concussions can increase the time it takes to recover. In rare cases, repeat concussions in young athletes can result in brain swelling or permanent damage to their brain. They can even be fatal.

WHAT SHOULD YOU DO IF YOU THINK YOUR ATHLETE HAS A CONCUSSION?

If you suspect that an athlete has a concussion, remove the athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says s/he is symptom-free and it’s OK to return to play. Rest is key to helping an athlete recover from a concussion. Exercising or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games, may cause concussion symptoms to reappear or get worse. After a concussion, returning to sports and school is a gradual process that should be carefully managed and monitored by a health care professional. Remember Concussions affect people differently. While most athletes with a concussion recover quickly and fully, some will have symptoms that last for days, or even weeks. A more serious concussion can last for months or longer. It’s better to miss one game than the whole season.

For more information on concussions, visit: www.cdc.gov/Concussion.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS AND HAVE HAD ALL MY QUESTIONS FULLY ANSWERED, FULLY UNDERSTAND THAT I HAVE THE CHOICE OF NOT PARTICIPATING IN THE GUS PROGRAMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

COVID-19

I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that the Swimmer, myself and spouse and our heirs, and I may be exposed to or infected by COVID-19 while onsite at any GUS Program, 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 at any GUS Program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the Releasees. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury, illness, permanent disability, death, damage, and/or Losses that the Swimmer, myself and spouse and our heirs, or I may experience, sustain, or incur in connection with any attendance at any GUS Program (collectively, “Claims”). I hereby release, covenant not to sue, discharge, and hold harmless the Releasees of and from the Claims, including all Losses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of any Releasees and whether a COVID-19 infection occurs before, during, or after participation in any event operated by the Releasees.

PHOTO RELEASE

The Releasees have my permission to use Swimmer’s, or my photograph publically to promote Grown-Up Swimming, LLC and GUS Programs. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

MARKETING RELEASE

The Releasees have my permission to contact me about GUS Programs, offers, and advertisements as well as share my contact information within the GUS Programs network, including but not limited to sponsors and partners.

INAPPROPRIATE BEHAVIOR

All swimmers and guests are expected to behave appropriately. If a swimmer has behavior that is inappropriate (as determined by the Releasees, team captains, team reps, and/or coaches), the Grown-Up Swimming may be required to take disciplinary action which can include expulsion from any GUS Program without any refund.