Liza's Lagoon Waiver Release
Please select who will be participating:
First Minor's Information
or
Second Minor's Information
or
Third Minor's Information
or
Fourth Minor's Information
or
Fifth Minor's Information
or
Sixth Minor's Information
or
I hereby assume
all risks in using the Pond Facility and Pavilion voluntarily for myself and child.
I indemnify, release from liability, agree to
defend and hold harmless Wisconsin Riverside Resort and any of
their officers, directors, employees, agents,
insurance carriers and representatives for any accident, injury, illness,
death, loss, theft, damage to person or property, or other consequences
suffered by myself or my child’s use of the Pond Facility, including but not
limited to, claims arising from or related to Wisconsin Riverside Resort’s
negligence and/or products liability.
In the event that I or my child
is injured, I agree to assume any financial obligation, either through my
health insurance, or through some other means, for any medical costs that I or
my child incurs. Wisconsin Riverside Resort assumes no responsibility for any
medical expenses, injury, or damage suffered by me or my child in connection
with my or my child’s use of the Pond Facility.
I am aware of the potential dangers incidental to the use of the Pond
Facility and Pavilion, that this is a release of liability, a waiver of my
legal right to collect damages in the event of injury, death or property
damage, and a contract between Wisconsin Riverside Resort and me, and I sign it
of my own free will. I expressly agree that this release is intended to be as
broad and inclusive as the State of Wisconsin will allow and that if any
portion is held invalid, I agree that the balance shall, not withstanding,
continue in full legal force and effect.
Parental/Guardian
Consent:
I
certify that I am the parent or legal guardian of the above participant and
that I am entitled to his or her custody and control. I do hereby give permission
for the child to use the Pond Facility. I further certify that the child is in
good health and has no physical or other impediment which would endanger him or
her while using the Pond Facility. I realize that the child may be exposed to a
risk of injury or death. I understand the dangers incidental to using the Pond
Facility and the need for safety precautions, and I have discussed these dangers
and the need for safety precautions with the child. I understand that there is
NO LIFEGUARD ON DUTY AT ANY TIME and that the child must be accompanied by an
adult at all times while in the Pond Facility.
I have read,
fully understand and accept this Release, Waiver of Liability and Assumption of
Risk for the use of Wisconsin Riverside Resort’s Pond Facility on his/her
behalf.
POND SAFETY
& RULES
Adult
supervision required for anyone 12 & under
NO LIFEGUARD ON
DUTY
Swim At Your Own
Risk
No Pets Allowed
Life Jackets Are
Available
No Diving,
Pushing or Jumping off Inflatables
No Throwing
Dangerous Objects
Clean Up After
Yourselves
No Glass
Containers
Please be
Considerate to Others
We Reserve the
Right to Ask Anyone to Leave for Any Reason
This waiver is good only for the date selected:
OR this waiver is good for the 2022 season: (please chose this option if you are purchasing a season pass)
Please enter your first and last name
Email Address