Name: Spouse's Name: Street Address: Phone: Resident 2024053847 Page 6 of 11 ATTACHMENT 10 EAST VILLAGE RESIDENTIAL COMMUNITY, INC.
Pool Registration Form and Usage Release Agreement Cell: Cell: Email 1: .
Email 2: Tenant Corporate Owner of Property.
Registered East Village Residents For Pool Access: Name Name Name Name Phone: Phone: Relation Age Name Relation Age Relation Age Name Relation Age Relation Age Name Relation Age Relation Age Name Relation Age I. AUTHORIZATION, WAIVER, AND INDEMNIFICATION BY PARENT(S) OR LEGAL GUARDIAN(S) (MINOR CHILD(REN) UNDER 18). I, FOR MYSELF, MY HEIRS, AND FOR ANY MINOR CHILDREN LISTED BELOW (EACH, A "USER"), HOLD HARMLESS AND RELEASE EAST VILLAGE RESIDENTIAL COMMUNITY, INC. (THE "COMMUNITY"), AND THE COMMUNITY'S MANAGERS, AGENTS, EMPLOYEES, AFFILIATES, OFFICERS, AND DIRECTORS (THE “RELEASED PARTIES"), FROM ANY AND ALL CLAIMS, CAUSES OF ACTION, DEMANDS, LOSSES, DAMAGES, EXPENSES, AND COSTS, INCLUDING, BUT NOT LIMITED TO, ANY CLAIM FOR PERSONAL INJURY OR PROPERTY DAMAGE, INCLUDING DEATH, ARISING OUT OF OR RELATING IN ANY WAY TO USE OF THE COMMUNITY'S FACILITIES OR PROPERTY (THE "PROPERTY"), INCLUDING ANY SUCH CLAIMS ARISING OUT OF OR CAUSED BY ANY ACT OR OMISSION BY THE RELEASED PARTIES, INCLUDING ANY NEGLIGENT ACTS BY THE RELEASED PARTIES, AND AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASED PARTIES FROM AND AGAINST ANY AND ALL LOSSES, DAMAGES, COSTS, AND LIABILITIES ARISING OUT OF OR CONNECTED WITH SUCH USER'S USE OF THE PROPERTY, INCLUDING ANY NEGLIGENT ACTS BY THE RELEASED PARTIES.
II. Authorization of Medical Treatment In the event that I cannot be reached, I authorize and direct any employee or agent representing the Community to make emergency medical decisions for the child(ren), and release the Community from
nt In the event that I cannot be reached, I authorize and direct any employee or agent representing the Community to make emergency medical decisions for the child(ren), and release the Community from liability for the cost of such medical treatment.
4867-0634-6408v.1 55663-114 ATTACHMENT 10 EAST VILLAGE SECOND SUPPLEMENT TO COMMUNITY MANUAL 2024053847 Page 7 of 11 III. Applicable Rules I acknowledge and agree that I shall be bound at all times by the terms and conditions of the policies, rules and regulations of the Community, as currently in effect and as may be amended from time to time.
IV. Photo Release By selecting YES, I acknowledge and agree that images of me and my family may be used in promotional materials for the Community which may be published in print, video, or digital format. YES NO V. Constant Contact Would you like to be added to our email distribution list: YES NO I have read and understand the terms of these Authorization and Waivers and have willingly signed below as my own free act, being both of lawful age and legally competent to do so.
Print Name: Signature:_ Date: Print Name: Signature: Date: Key Fob Number Number Key Fob Number Remote Clicker Number Remote Clicker Key Fob Number Number Key Fob Number Remote Clicker Number Remote Clicker ATTACHMENT 10 EAST VILLAGE SECOND SUPPLEMENT TO COMMUNITY MANUAL 4867-0634-6408v.1 55663-114