Important Information:
You are solely responsible for determining if you are physically fit and/or skilled for the activities associated with this program. It is always advisable, especially if you are disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity.

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, you will be waiving and releasing all claims for your injuries you might sustain arising out of the activities of this program.

“As a participant in this program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which I may sustain as a result of participating in any and all activities connected with or associated with this program. I agree to waive and relinquish all claims I may have as a result of participating in the program against the Association of Illinois Senior Centers, Illinois Department on Aging, the host organization and their officers, agents, servants, volunteers, and employees. I do hereby fully release and discharge the Association of Illinois Senior Centers, Illinois Department on Aging, and the host organization and their officers, agents, servants, volunteers, and employees from any and all claims from injuries including death, damages of loss which I may have or which may accrue to me on account of participation.”