Agreement and Release of Liability Recreation Waiver
The Agreement and Release of Liability Waiver is required to be completed prior to participating in any events, programs, or activities. The full text of the waiver is below and is required to be signed once per year. Please contact the front desk with any questions.
RELEASE OF LIABILITY: In consideration for myself and/or my minor child(ren) being permitted by the City of Coronado (“City”) to participate in recreational activities and/or use City facilities, I hereby waive, release and discharge any and all claims and damages for personal injury, death, or property damage which I, or my minor child(ren), may sustain or which may occur as a result of my participation, or my minor child(ren)’s participation, in these activities or use of City facilities.
I understand and agree that: (a) recreational and fitness activities and use of City facilities (cumulatively “recreational activities”) have inherent risks, dangers, and hazards and such exists in my use, and/or my minor child(ren)’s use, of any equipment and my participation in these activities; (b) my participation, and/or my minor child(ren)’s participation, in such activities and/or use of such equipment may result in injury or illness including, but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, death, or other ailments that could cause serious disability; (c) City facilities are open and generally accessible to members of the public; (d) my and/or my minor child(ren)’s and/or other users access to City facilities and/or placement, storage or accessing of property left in City facilities puts such property at a risk of damage, destruction, loss, theft, fire or other casualty; (e) these risks and dangers may be caused by the negligence of the representatives, employees, or volunteers of the City of Coronado, the negligence of the participants, the negligence of others, accidents, breaches of contract, or other causes; and (f) by my participation, and/or my minor child(ren)’s participation, in recreational activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages whether caused in whole or in part by the negligence or conduct of the representatives, employees, or volunteers of the City of Coronado.
My participation, or my minor child(ren)’s participation, in recreational activities may occasionally result in injury, death or property damage.
Knowing the risk involved, nevertheless, I voluntarily request permission for myself or minor child(ren) to participate in the recreational activity. As lawful consideration for permission to enter City property and/or City facilities for any purpose, including but not limited to observation, use of facilities or equipment, leaving or storage of property, or participation in any way, I agree to release from any legal liability to me or to my personal representatives, assigns, heirs, and next of kin, and agree not to sue the City of Coronado, its elected and appointed officers, agents, representatives, volunteers and employees (the “Releasees”), for any loss or damage, including all injuries, death, or property damage caused by or resulting from any use of City facilities, or participation in, or observation of, recreational activities, whether or not such injury, death, or property damage was caused by alleged negligence of the Releasees, or any of them.
To the maximum extent permissible by law, this release is intended to discharge in advance the City, its officers, employees and agents from and against any and all liability connected in any way with my participation, or my minor child(ren)’s participation, in recreational activities or any use of City facilities. I agree to indemnify, defend (with counsel acceptable to City), and hold harmless the Releasees, from any and all claims asserted or liability established for damages or injuries to any person or property, that arise out of or are in any manner directly or indirectly connected with my use of City facilities or participation in recreational activities, and all expenses of investigating and defending against the same, including any claims or liability arising from the active negligence of the Releasees unless otherwise prohibited by law.
I hereby acknowledge and agree that participation in recreational activities and the use of City of Coronado property, services, facilities, programs, classes, or other sponsored recreational activities has inherent risks. Those risks include, but are not limited to, all manner of injury resulting from negligent misuse of City facilities or equipment; falling off and/or impacting against City property, facilities, equipment, projections (permanently or temporarily in place), and floor; slips, trips, falls, or other, in using City facilities or equipment; negligence or intentionally wrongful conduct of other participants, visitors, or persons who may be present during the recreational activities.
I also hereby acknowledge and agree that certain recreational activities, like use of a skatepark, are hazardous and creates a substantial risk of injury to myself and/or my minor child(ren). I agree, represent and warrant that I and my minor child(ren) are twelve (12) years of age and will wear a commercially manufactured helmet, elbow pads and knee pads at all times while using the skatepark. I understand and acknowledge that despite the use of such protective gear, using the skatepark could result in injury, death or property damage.
I further recognize the inherent risks of damage to, or loss of, any property associated with my use of City facilities, arising from any cause whatsoever, whether foreseeable or not, including, but not limited to: fire, theft, vandalism, water damage, mysterious disappearance, rodents, acts of god, disease, pandemic or the active or passive acts or omission or negligence of the Releasees or any third party.
I hereby assume any and all risks of injury, death, or property damage and, on behalf of myself and/or my minor child(ren), release and hold harmless the Releasees, excepting only loss, injury, damage or costs that arise out of the City’s intentional wrongful acts or violations of law. I further agree and understand that all of my rights against the City under Section 1542 of the Civil Code of the State of California and any similar law of any state or territory of the United States hereby expressly waive such rights. Section 1542 reads as follows: “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.”
I agree to be responsible to follow, and ensure that my minor child(ren) follow, any safety rules and procedures established by the City of Coronado in connection with recreational activities.
I hereby acknowledge, agree, and represent that I have, or immediately upon entering, will inspect the facility, equipment, and the surrounding premises, and I further warrant that my participation in recreational activities, including but not limited to participation, observation, or use of facilities or equipment, constitutes an acknowledgement that such premises and all facilities and equipment thereon have been inspected and that the undersigned finds and accepts the same as being safe and reasonably suited for the purposes of such observation or use.
I acknowledge that novel coronavirus SARS-CoV-2, also known as COVID-19 (hereinafter ''COVID-19") infections have been confirmed throughout the United States. In accordance with the most recent guidance and protocols issued by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the California Department of Health for slowing the transmission of COVID-19, I hereby agree, represent, and warrant that neither I nor my minor child(ren) shall visit or use the facilities, services, and programs of the City (other than any exclusively online services and programs) within 14 days after (a) returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice, (b) exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or (c) exposure to any person who has a suspected or confirmed case of COVID-19. The CDC Travel Health Network is continuously updating this list and I agree that I am aware of this list and the countries listed.
I agree to check the CDC Travel Health Notices list (https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html) prior to using the facilities, services, and programs of the City, on a daily basis if necessary. I hereby agree, represent, and warrant that neither I nor my minor child(ren) shall visit or use the facilities, services, and programs of the City if I, or my minor child(ren), (a) experience symptoms of COVID-19, including, without limitation, fever, cough, or shortness of breath, or (b) have a suspected, diagnosed, or confirmed case of COVID-19. I agree to notify City staff immediately if I believe that any of the foregoing access or use restrictions may apply.
The City has taken certain steps to implement recommended guidance and protocols issued by the Public Health Agencies for slowing the transmission of COVID-19, including, without limitation, the access and use restrictions set forth above. I acknowledge and agree that the City may revise its procedures at any time based on updated recommended guidance and protocols issued by the Public Health Agencies and further agree to comply with the City’s revised procedures prior to using the facilities, services, and programs. I further acknowledge and agree that, due to the nature of the facilities, services, and programs offered by the City, social distancing of six (6) feet per person among participants and staff is not always possible. I fully understand and appreciate both the known and potential dangers of utilizing the facilities, services, and programs of the City and acknowledge that use thereof by myself and/or my minor child(ren) may, despite the City’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death.
I agree that this AGREEMENT AND RELEASE OF LIABILITY is intended to be as broad and inclusive as is permitted by law. Any provision found to be invalid or unenforceable by a court shall not affect the validity or enforceability of any other provision.
I am aware that this AGREEMENT AND RELEASE OF LIABILITY is legally binding and that I am releasing legal rights by signing it. This AGREEMENT AND RELEASE OF LIABILITY is binding on my heirs, personal representatives, next of kin, successor, executors and assigns.
I consent to the use of electronic media and agree that my electronic signature and/or initials on this AGREEMENT AND RELEASE OF LIABILITY is legally binding and that a true copy can be used for all purposes.
MEDICAL TREATMENT (SELF): In connection with any injury I may sustain, or illness or other medical conditions I may experience, during my participation in recreational activities, I authorize any emergency first aid, medication, medical treatment, or surgery deemed necessary by attending medical personnel if I am not able to act on my own behalf. I understand that I will be responsible for any expenses incurred on my behalf in connection with such treatment.
MEDICAL TREATMENT (MINOR CHILD OR CHILDREN): In connection with any injury my minor child(ren) may sustain, or illness or other medical conditions my minor child(ren) may experience, during his or her participation in recreational activities, I, the undersigned parent(s) or legal guardian(s) of the above minor child(ren), do hereby authorize the City and/or any California Hospital as agents for the undersigned to consent, in advance of any specific diagnosis, to any x-ray examination, anesthetic medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or specific supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any California Hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. This authorization is given pursuant to Section 1283 of the Health and Safety Code of California, and shall remain effective until revoked in writing by a parent or guardian.
CONCUSSION INFORMATION SHEET ACKNOWLEDGEMENT
I acknowledge that I have received and reviewed the Concussion Information Sheet that is attached as Attachment A to this AGREEMENT AND RELEASE OF LIABILITY and fully incorporated herein by this reference.
SUDDEN CARDIAC ARREST INFORMATION SHEET ACKNOWLEDGEMENT
I acknowledge that I have received and reviewed the Sudden Cardiac Arrest Information Sheet for Athletes & Parents/Guardians that is attached as Attachment B to this AGREEMENT AND RELEASE OF LIABILITY and fully incorporated herein by this reference.
OPIOID FACTSHEET ACKNOWLEDGEMENT
I acknowledge that I have received and reviewed the opioid factsheet for patients entitled: “Prescription Opioids: What You Need to Know” that is attached as Attachment C to this AGREEMENT AND RELEASE OF LIABILITY and fully incorporated herein by this reference.
CERTIFICATION: I certify that I am the person named above and (if applicable) the parent of the minor child(ren) named above, or I have custody or am the legal guardian of said minor(s) by court order, if any. I further certify that I am, and my minor child(ren) is (are), physically able to participate in the recreational activities. I have carefully read this AGREEMENT AND RELEASE OF LIABILITY, including all attachments, fully understand the contents and agree to all the terms and conditions stated herein. I sign this of my own free will.
CONCUSSION INFORMATION FACT SHEET (Attachment A)
This sheet has information to help protect your children or teens from concussion or other serious brain injury. Use this information at your children’s or teens’ games and practices to learn how to spot a concussion and what to do if a concussion occurs.
What Is a Concussion?
A concussion is a type of traumatic brain injury—or TBI— caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move quickly back and forth. This fast movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging the brain cells.
How Can I Help Keep My Children or Teens Safe?
Sports are a great way for children and teens to stay healthy and can help them do well in school. To help lower your children’s or teens’ chances of getting a concussion or other serious brain injury, you should:
- Help create a culture of safety for the team. When appropriate for the sport or activity, teach your children or teens that they must wear a helmet to lower the chances of the most serious types of brain or head injury. However, there is no “concussion-proof” helmet. So, even with a helmet, it is important for children and teens to avoid hits to the head.
- Work with their coach to teach ways to lower the chances of getting a concussion.
- Talk with your children or teens about concussion and ask if they have concerns about reporting a concussion.
- Talk with them about their concerns; emphasize the importance of reporting concussions and taking time to recover from one.
- Ensure that they follow their coach’s rules for safety and the rules of the sport.
- Tell your children or teens that you expect them to practice good sportsmanship at all times.
How Can I Spot a Possible Concussion?
Children and teens who show or report one or more of the signs and symptoms listed below—or simply say they just “don’t feel right” after a bump, blow, or jolt to the head or body—may have a concussion or other serious brain injury.
Signs Observed by Parents or Coaches
- Appears dazed or stunned
- Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent
- Moves clumsily
- Answers questions slowly
- Loses consciousness (even briefly)
- Shows mood, behavior, or personality changes
- Can’t recall events prior to or after a hit or fall
Symptoms Reported by Children and Teens
- Headache or “pressure” in head
- Nausea or vomiting
- Balance problems or dizziness, or double or blurry vision
- Bothered by light or noise
- Feeling sluggish, hazy, foggy, or groggy
- Confusion, or concentration or memory problems
- Just not “feeling right,” or “feeling down”
What Are Some More Serious Danger Signs to Look Out For?
In rare cases, a dangerous collection of blood (hematoma) may form on the brain after a bump, blow, or jolt to the head or body and can squeeze the brain against the skull. Call 9-1-1 or take your child or teen to the emergency department right away if, after a bump, blow, or jolt to the head or body, he or she has one or more of these danger signs:
- One pupil larger than the other
- Drowsiness or inability to wake up
- A headache that gets worse and does not go away
- Slurred speech, weakness, numbness, or decreased coordination
- Repeated vomiting or nausea, convulsions or seizures (shaking or twitching)
- Unusual behavior, increased confusion, restlessness, or agitation
- Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously
What Should I Do If My Child or Teen Has a Possible Concussion?
As a parent, if you think your child or teen may have a concussion, you should:
- Remove your child or teen from play.
- Keep your child or teen out of play the day of the injury. Your child or teen should be seen by a healthcare provider and only return to play with permission from a healthcare provider who is experienced in evaluating for concussion.
- Ask your child’s or teen’s healthcare provider for written instructions on helping your child or teen return to school. You can give the instructions to your child’s or teen’s school nurse and teacher(s) and return-to-play instructions to the coach and/or athletic trainer.
Do not try to judge the severity of the injury yourself. Only a healthcare provider should assess a child or teen for a possible concussion. Concussion signs and symptoms often show up soon after the injury. But you may not know how serious the concussion is at first, and some symptoms may not show up for hours or days.
The brain needs time to heal after a concussion. A child’s or teen’s return to school and sports should be a gradual process that is carefully managed and monitored by a healthcare provider.
Children and teens who continue to play while having concussion symptoms, or who return to play too soon—while the brain is still healing—have a greater chance of getting another concussion. A repeat concussion that occurs while the brain is still healing from the first injury can be very serious, and can affect a child or teen for a lifetime. It can even be fatal.
While most children and teens with a concussion feel better within a couple of weeks, some will have symptoms for months or longer. Talk with your children’s or teens’ healthcare provider if their concussion symptoms do not go away, or if they get worse after they return to their regular activities.
Talk with your children and teens about concussion.
Tell them to report their concussion symptoms to you and their coach right away. Some children and teens think concussions aren’t serious, or worry that if they report a concussion they will lose their position on the team or look weak. Be sure to remind them that it’s better to miss one game than the whole season.
For more information, visit the CDC Heads Up website.
SUDDEN CARDIAC ARREST FACT SHEET (Attachment B)
What is sudden cardiac arrest?
Sudden cardiac arrest (SCA) is when the heart stops beating, suddenly and unexpectedly. When this happens blood stops flowing to the brain and other vital organs. SCA is NOT a heart attack. A heart attack is caused by a blockage that stops the flow of blood to the heart. SCA is a malfunction in the heart’s electrical system, causing the victim to collapse. The malfunction is caused by a congenital or genetic defect in the heart’s structure.
How common is sudden cardiac arrest in the United States?
As the leading cause of death in the U.S., there are more than 300,000 cardiac arrests outside hospitals each year, with nine out of 10 resulting in death. Thousands of sudden cardiac arrests occur among youth each year, as it is the #1 killer of student athletes and the leading cause of death on school campuses.
Who is at risk for sudden cardiac arrest?
SCA is more likely to occur during exercise or physical activity, so student-athletes are at greater risk. While a heart condition may have no warning signs, studies show that many young people do have symptoms but neglect to tell an adult. This may be because they are embarrassed, they do not want to jeopardize their playing time, they mistakenly think they’re out of shape and need to train harder, or they simply ignore the symptoms, assuming they will “just go away.” Additionally, some health history factors increase the risk of SCA.
What should you do if your student-athlete is experiencing symptoms?
We need to let student-athletes know that if they experience any SCA-related symptoms it is crucial to alert an adult and get follow-up care as soon as possible with a physician, surgeon, nurse practitioner or physician assistant. If the athlete has any of the SCA risk factors, these should also be discussed with a doctor to determine if further testing is needed. Wait for your doctor’s feedback before returning to play, and alert your coach, trainer and school nurse about any diagnosed conditions.
What are we doing to help protect student athletes?
The State of California passed the Eric Paredes Sudden Cardiac Arrest Prevention Act in 2016 to protect K-12 students participating in school-sponsored athletic activities. New policy adds sudden cardiac arrest (SCA) training to coach certification, and new protocol that empowers coaches to remove from play a student-athlete who exhibits fainting—the number one warning sign of a potential heart condition, and potentially for other conditions if they are believed to be cardiac related. A student-athlete who has been removed from play after displaying signs or symptoms associated with SCA may not return to play until he or she is evaluated and cleared by a licensed health care provider. Parents, guardians, caregivers and adults involved in athletic activities are urged to dialogue with student-athletes about potential warning signs and risk factors and be familiar with the cardiac chain of survival so they are prepared in the event of a cardiac emergency.
Cardiac Chain of Survival
On average it takes EMS teams up to 12 minutes to arrive to a cardiac emergency. Every minute delayed in attending to a sudden cardiac arrest victim decreases the chance of survival by 10%. Everyone should be prepared to take action in the first minutes of collapse.
- Recognition of Sudden Cardiac Arrest
- Victim is collapsed, unresponsive and not breathing, even if gasping, gurgling, exhibiting breathing noises or seizure-like activity.
- Call 9-1-1
- Follow emergency dispatcher's instructions. Call any on-site Emergency Responders.
- Hands-Only CPR
- Begin CPR immediately. Hands-only CPR involves fast and continual two-inch chest compressions - about 100 per minute.
- Immediately retrieve and use an automated external defibrillator to restore the heart to its normal rhythm. Follow step-by-step audio instructions from the AED.
- Advanced Care
- Designate a bystander to direct EMS to the victim for quick transfer to the hospital.
What is an AED?
An automated external defibrillator (AED) is the only way to save a sudden cardiac arrest victim. An AED is a portable, user friendly device that automatically diagnoses potentially life threatening heart rhythms and delivers an electric shock to re store normal rhythm. Anyone can operate an AED, regardless of training. Simple audio direction instructs the rescuer when to press a button to deliver the shock, while other AEDs provide an automatic shock if a fatal heart rhythm is detected. A rescuer cannot accidently hurt a victim with an AED quick action can only help. AEDs are designed to only shock victims whose hearts need to be restored to a healthy rhythm. Check with your school for locations of on campus AEDs.
OPIOID FACT SHEET (Attachment C)
Prescription opioids can be used to help relieve moderate-to-severe pain and are often prescribed following a surgery or injury, or for certain health conditions. These medications can be an important part of treatment but also come with serious risks. It is important to work with your health care provider to make sure you are getting the safest, most effective care.
What are the risks and side effects of opioid use?
Prescription opioids carry serious risks of addiction and overdose, especially with prolonged use. An opioid overdose, often marked by slowed breathing, can cause sudden death. The use of prescription opioids can have a number of side effects as well, even when taken as directed:
- Tolerance—meaning you might need to take more of a medication for the same pain relief
- Physical dependence—meaning you have symptoms of withdrawal when a medication is stopped
- Increased sensitivity to pain
- Nausea, vomiting, and dry mouth
- Sleepiness and dizziness
- Low levels of testosterone that can result in lower sex drive, energy, and strength
- Itching and sweating
Risks are greater with:
- History of drug misuse, substance use disorder, or overdose
- Mental health conditions (such as depression or anxiety)
- Sleep apnea
- Older age (65 years or older)
Know your options:
Talk to your health care provider about ways to manage your pain that don’t involve prescription opioids. Some of these options may actually work better and have fewer risks and side effects. Options may include:
- Pain relievers such as acetaminophen, ibuprofen, and naproxen
- Some medications that are also used for depression or seizures
- Physical therapy and exercise
- Cognitive behavioral therapy, a psychological, goal- directed approach, in which patients learn how to modify physical, behavioral, and emotional triggers of pain and stress.
If you are prescribed opioids for pain:
- Never take opioids in greater amounts or more often than prescribed.
- Follow up with your primary health care provider within 5 days.
- Work together to create a plan on how to manage your pain.
- Talk about ways to help manage your pain that don’t involve prescription opioids.
- Talk about any and all concerns and side effects.
- Help prevent misuse and abuse.Store prescription opioids in a secure place and out of reach of others (this may include visitors, children, friends, and family).
- Never sell or share prescription opioids.
- Never use another person’s prescription opioids.
- Safely dispose of unused prescription opioids: Find your community drug take-back program or your pharmacy mail-back program, or flush them down the toilet, following guidance from the Food and Drug Administration.
- Visit the CDC to learn about the risks of opioid abuse and overdose.
- If you believe you may be struggling with addiction, tell your health care provider and ask for guidance or call SAMHSA’s National Helpline at
Avoid alcohol while taking prescription opioids. Also, unless specifically advised by your health care provider, medications to avoid include:
- Benzodiazepines (such as Xanax or Valium)
- Muscle relaxants (such as Soma or Flexeril)
- Hypnotics (such as Ambien or Lunesta)
- Other prescription opioids
Be Informed! Make sure you know the name of your medication, how much and how often to take it, and its potential risks and side effects.
NAME AND LIKENESS RELEASE:
I understand City staff may photograph or videotape me and/or my minor child(ren) while I am, or my minor child(ren) is (are), on or using City property and/or participating in City programs, classes, or other sponsored recreational activities. In further consideration for myself and/or my minor child(ren) being permitted by the City to participate in recreational activities, the City may use my name and likeness, or my minor child(ren)’s name(s) and likeness(es) in connection with my participation in the recreational activities and/or my, or my minor child(ren)’s, use of City property or facilities. I expressly allow the City to photograph or videotape me and/or my minor child(ren) when I, or my minor child(ren), participate in the recreational activities, and I hereby waive any objection to the same. The City may use my, and/or my minor child(ren)’s, name, likeness, or any photographs or videotape of me or my minor child(ren) in connection with the use of City facilities and recreational activities in any City publication, including news releases and/or to promote City programs and classes, without my prior consent. I understand all photographs and videotape will remain the property of the City of Coronado, and further agree that I am, and/or my minor child(ren) is (are), not entitled to compensation for such use.
You may opt out of the "Name and Likeness" section of the waiver by selecting "No" to opt out of Name and Likeness Release during the prompt for your activity.