Choose To Swim LLC
To all Parents, Guardians, Caregivers and Friends,
I am sending you the waiver form for you to read and sign. Nancy Pleiter-Sadowy is very fortunate to offer the Meadowmere Resort as a facility for therapy and water safety instruction Meadowmere Resort is offering this facility with the understanding their place of business will be respected. I expect all patrons to respect the facility before, during and after lessons. For reasons of safety, Nancy Pleiter-Sadowy has the right to ask you to refrain from participating in the Choose To Swim LLC program. I expect all patrons to follow and abide by these rules to ensure the continued use of this facility. I have the right to terminate services at any time if the following policies and procedures are not adhered to.
Waiver forms from Choose To Swim LLC need to be signed before participation begins.
Patrons are asked to enter/exit through the Main Entrance. When passing the lobby, please sign in on the indoor pool log book at the front desk. The pool is straight ahead through the atrium. Please pass through quietly and enter the pool area. A restroom/changing area is located in the back of the pool area.
My responsibility for a student begins at the beginning of our lesson and ends when the class is finished. The parent/guardian/caregiver is to remain in the pool area during the lesson. Children are not to wander along the pool deck or outside the facility unattended. Please note the pool remains open to guests during the pool reservation.
I acknowledge_______________________is receiving swim instruction from Nancy Pleiter-Sadowy at Meadowmere Resort located in Ogunquit, ME. I understand swimming involves risks. He/She, with supervision and support, will exercise, jump in deep water and learn basic water safety skills. I fully understand and agree that Nancy will not be held liable for medical or dental expenses incurred as a result of he/she swimming at the pool. I agree that I have adequate medical insurance to cover an injury and all bills will be forwarded to and paid for by my insurance company. He/She is in good physical health and able to participate in vigorous physical activity. In the event of illness or injury, Nancy has my permission to provide first aid and seek medical care.
Medical condition: _________________________________________________________________
In case of emergency contact: __________________________Phone: _________________________
I/We have read the above and thoroughly understand the risks involved in an instructional program.
I/We understand I/We may contact Nancy Pleiter-Sadowy with any questions or concerns.
______________________________________________________________________________
Signature of Parent, Guardian, Caregiver Date
“I agree to give Nancy Pleiter-Sadowy permission in conjunction with any photographs/videos taken of me/my child(ren), or in which I/my child(ren) are included with others, the right to use and reuse, in any manner at all photographs/videos in whole or part, either by themselves or in conjunction with other photographs/videos, in any medium and for the purposes whatsoever, including, without limitation, all promotional and advertising and other trade purposes. I hereby release Choose To Swim LLC from any and all claims, actions and demands arising out of or in conjunction with the use of said photographs/videos”.
Signature of Parent, Guardian, Caregiver (if under 18) Date
Address City, State, Zip Phone
Limitations: ________________________________________________________________________
Nancy Pleiter-Sadowy * 58 New Road Arundel, ME 04046 * 207.282.0723 * 603.781.1071 * npsctsllc@roadrunner.com