PARENTS' OR LEGAL GUARDIANS' REQUEST FOR CHILD'S PARTICIPATION IN JUNIOR PROGRAM AND ASSUMPTION OF RISK AGREEMENT (THIS 'AGREEMENT')

The undersigned parents or legal guardians (hereafter referred to in the singular) of the following named child (my "child"):

request that the child be allowed to participate in the following Atlanta Yacht Club program (the "Program"):

THIS AGREEMENT will remain in effect until Atlanta Yacht Club (the "Yacht Club") receives written notice of the cancellation hereof.

In return for my child being permitted to take part in the Program and to use the facilities and property of the Yacht Club, each of the undersigned makes the following promises and warrants the truth of the following facts:

1. PROGRAM PARTICIPATION: I am familiar with the activities included in the Program, and understand that officers and volunteer members of the Yacht Club who will comprise the senior staff for the Program are available to discuss the Program and its activities if I should wish additional information. I also understand I am solely responsible for the arrival and departure of my child at the beginning and end of each scheduled day of the Program (or, if the Program involves staying overnight, at the beginning and end of the scheduled Program). I acknowledge and stipulate that the Yacht Club will have no responsibility for the supervision of my child at times other than during the scheduled Program. I shall inform my child that he/she is expected to cooperate with, and follow the directions of, the Yacht Club's designated supervisors, staff, and instructors conducting the Program activities and to act in a manner consistent with the spirit of good sportsmanship and respect both for the rights of others and for the property of others. [Please initial to indicate you have read this paragraph. ;]

2. HEALTH: My child is in good health, and I know of no reason why he/she would be incapable of participating in the Program activities. My child knows how to swim. I shall immediately notify the Yacht Club's designated Program supervisor, if a change in my child's health or other condition would affect my child's ability to participate in the Program activities. [Please initial to indicate you have read this paragraph. ;]

3. ASSUMPTION OF RISK: I am aware that the Program activities may involve maneuvering a boat, sailboard, or other watercraft on deep waters in potentially hazardous conditions that may include, among other things, strong winds and high waves, sudden and unexpected immersion in deep waters and collision with other watercraft or stationary objects such as docks, pilings, and buoys. With knowledge of the dangers involved, I voluntarily ask that my child be allowed to take part in the Program activities. I ACCEPT ANY AND ALL RISKS TO MYSELF AND MY CHILD OF INJURY, DEATH, AND PROPERTY DAMAGE ARISING FROM PARTICIPATION IN THE PROGRAM ACTIVITIES AND THE USE OF THE FACILITIES AND PROPERTY OF THE YACHT CLUB. [Please initial to indicate you have read this paragraph. ;]

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS AGREEMENT INCLUDES AN ASSUMPTION OF RISK ACKNOWLEDGEMENT CONCERNING THE RISKS INHERENT IN MY CHILD'S PARTICIPATION IN THE PROGRAM, AND I SIGN IT OF MY OWN FREE WILL.

DATE:

PARENT OR LEGAL GUARDIAN:

[Signature]

[Print Name]

PARENT OR LEGAL GUARDIAN :

[Signature]

[Print Name]

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