06/04/2025
Here is the promised waiver and release form. Thank you for your patience.
RELEASE & WAIVER OF LIABILITY
This Release and Waiver of Liability executed this ____ day of ______________, 20__ by _____________________ and _____________________, hereinafter referred to as "Releasors", individually and as parents and guardian of ____________________________, a minor, to Shannon K. Larsen Owner, Tara K. Larsen, Angela L. Kendall Instructors, & Hereinafter referred to as "Releasees".
R E C I T A L S
1. Releasees are the owners of a swimming pool located at their residence at 2610 NW Ogden Court, Camas Washington, 98607.
2. Releasees Shannon K. Larsen, Owner, Tara K. Larsen, Angela L. Kendall, Instructors, while conducting swimming classes for preschool and adolescent children at the swimming pool.
3. Releasors desire to enroll the above named minor in the swimming classes conducted by Releasees.
NOW, THEREFORE, in consideration of being permitted to participate in the swimming classes conducted by Releasees Shannon K. Larsen, Tara K. Larsen, Angela L. Kendall, Releasors, with the intention of binding themselves and the above-named minor, their respective heirs, legal representatives and assigns, hereby release, waive, discharge and hold harmless Releasees and each of them from all claims, demands, causes of action, and all loss or damage arising out of injury to Releasors' or the above-named minor's person or property, including injury resulting in death, whether caused by the negligence of Releasees or otherwise while Releasors or the above-named minor is participating in the swimming classes conducted by Releasees.
Releasors for themselves and the above-named minor, assume full responsibility for the risk of bodily injury, death or property damage due to the negligence of Releasees or otherwise while in or upon the swimming pool located on Releasees' property and while participating in the swimming classes conducted by Releasees.
Releasors agree that this Release and Waiver of Liability Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Washington, and that if any portion of this Agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
The consideration stated in this Release is contractual and not a mere recital.
IN WITNESS WHERE OF, Releasors have executed this Release at Camas, Washington on this ____ day of ______________________, 20__.
________________________________________ ____________________________________
Releasor Releasor
STATE OF WASHINGTON )
) ss.
COUNTY OF CLARK )
On this _____ day of ________________, 20____, personally appeared before me ______________________________, to me known to be the individual described herein and who executed the within and foregoing instrument, and acknowledged that he/she signed the same as his/her free and voluntary act and deed, for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this _____ day of ________________, 20___.
__________________________________
Notary Public in and for the State of
Washington, Residing at ______________.
My appointment expires: ______
STATE OF WASHINGTON )
) ss.
COUNTY OF CLARK )
On this _____ day of ________________, 20___, personally appeared before me ______________________________, to me known to be the individual described herein and who executed the within and foregoing instrument, and acknowledged that he/she signed the same as his/her free and voluntary act and deed, for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this _____ day of ________________, 20___.
__________________________________
Notary Public in and for the State of
Washington, Residing at ______________.
My appointment expires
