Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Wrightsville Beach Parks & Recreation Program Participant Release/Waiver Form

  1. WBPR Navy Water Drop Logo 1 TRANSPARENT

  2. Wrightsville Beach Parks & Recreation Program Participant Release/Waiver Form

  3. Electronic Signature Agreement*

    Release/Waiver: I, the undersigned, desire for the person named as Participant above, to participate in the above named program/activity. I sign this Release, Waiver, Indemnity Agreement and Covenant Not to Sue (the "Agreement") in consideration of the Town of Wrightsville Beach permitting myself or my minor child to participate in the Program offered through the Town of Wrightsville Beach Parks and Recreation Department. I acknowledge that participation in this program/activity may involve strenuous physical activity. I further acknowledge that participation carries with it the potential for injury to myself or to my child. I state I or my child is in proper physical condition to participate in this program. I further understand that the Town of Wrightsville Beach, its staff and employees are under no obligation or duty to provide a physical examination or other evidence of my fitness to participate in this activity, such examination being my sole duty and responsibility. I agree to assume full responsibility for any injuries or loss which I or my child may sustain as a result of participating in any and all activities connected with or associated with such program. I do hereby release the Town of Wrightsville Beach, its officials, officers, agents, and employees from and waive all claims of whatsoever kind or nature that I or my child may have or which may accrue to me or my child at any time to include claims for injuries, damage or loss resulting from or on account of my participation or my child’s participation in this program. I further agree to indemnify and hold harmless and to defend the Released Parties from any and all claims resulting from injuries, damages and losses sustained by me or my child arising from or on account of my participation or my child’s participation in this program. I further covenant not to sue the Released Parties based on any and all claims resulting from injuries, damages and losses sustained by me or my child arising out of participation in this program. This Agreement shall be construed broadly to provide a release, waiver, indemnity and covenant not to sue to the maximum extent permissible under applicable law. I hereby certify that I have read this document and I understand its contents. I further agree that should Participant named above participate in live-stream or recorded Wrightsville Beach Parks and Recreation classes, I am agreeing to the following: I hereby release the Town of Wrightsville Beach and any instructors from responsibility for any injuries I or my child may sustain as a result of participation in the on-line re-recorded or live-streamed classes or programs presented by Wrightsville Beach Parks and Recreation including any online pre-recorded or live-streamed class. I am aware that the instructor cannot see me or my child and may not be able to offer personalized instruction, and therefore I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the classes offered by Wrightsville Beach Parks and Recreation. As determined by my physician and myself, I certify that the level of my physical condition will allow me or my child to safely participate in said programs. I hereby give permission for images of myself or my child, captured during the program through video, photo and digital camera, to be used solely for the purposes of Town of Wrightsville promotional material, newsletters, websites and publications and waive any rights of compensation or ownership thereto. Refunds: A full refund (less a $5 administrative fee) will be made if requested at least two weeks prior to the start of the program. If requested less than two weeks in advance, 20% will be retained as an administrative cost. If requested after the program has started, 40% plus a pro-rated amount for all days already conducted will be assessed, whether or not the participant named above was in attendance. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  4. Leave This Blank:

  5. This field is not part of the form submission.