Release of Liability and Hold Harmless Agreement
Bethany Lutheran Home for the Aged, Inc.

1.     I desire to use the Therapy Pool, Whirlpool, Fitness Center, and/or Group Exercise Studio/Community Center (the “Facilities”) located at Bethany  Home Brandon/Bethany Meadows. I understand and accept that use of the Facilities exposes me to a number of risks and  dangers. Some of the risks which may be present or occur include, but are not limited to, risk of death from drowning, injuries resulting from slipping or falling which could result in complete or partial paralysis, brain damage or other serious injury to my muscular skeletal system, injuries or disabilities arising from the contraction of infectious, communicable, or other diseases, injuries resulting from exposure to hot water, injuries from physical exertion, and serious injuries to other aspects of my general health and well being.

2.    Understanding the potential risks and consequences mentioned above, I hereby state that I am physically fit to use the Facilities.

3.    I have been informed of the rules pertaining to use of the Facilities and agree to abide by such rules. In the event I bring a guest to use the Facilities I will ensure that the guest completes and signs the Guest/Participant Waiver prior to using the Facilities.

4.    In consideration of my being allowed to use the Facilities and as a condition to the right to use the Facilities, I personally assume all risks incident to the use of the Facilities and I waive, release, and forever discharge, as permitted by law, Bethany Lutheran Home for the Aged, Inc., and its officers, directors, agents, employees, and representatives from all liabilities, losses, damages, claims, actions, causes of action, demands, or costs of any nature whatsoever that may arise in connection with my use of the Facilities, whether caused by the negligence of Bethany Lutheran Home for the Aged, Inc., its employees or agents, or caused by some other means.

5.    I further agree to indemnify and hold Bethany Lutheran Home for the Aged, Inc., its officers, directors, agents, employees, and representatives harmless from all liabilities, losses, damages, claims, actions, causes of actions, demands, or costs of any nature whatsoever that may arise in connection with my use of the Facilities, whether caused by the negligence of Bethany Lutheran Home for the Aged, Inc., or its employees or agents, or caused by some other means.

6.    Prior to signing this document, I have had an adequate opportunity to ask questions about it, and any questions I had have been answered to my satisfaction.

7.    This Release Agreement shall be binding upon me, my heirs, and personal representatives.