2021 Annual Dues - Nickel City Splash

January 1 - December 31, 2021

Fields with asterisk are required.
Waiver Agreement *

I HEREBY COVENANT AND AGREE WITH THE NICKEL CITY SPLASH MASTERS SWIM TEAM, THE UNIVERSITY AT BUFFALO, THE COACHES, OFFICERS, AGENTS, EMPLOYEES, AND ALL PERSONS ENGAGED AS COACHES OR ADMINISTRATORS IN ANY PROGRAMS IN WHICH I MAY BE A PARCIPANT, TO IDEMNIFY AND HOLD HARMLESS EACH AND EVERY ONE OF THEM FROM AND AGAINST ALL CLAIMS, LIABILITY, LOSS COST, DAMAGES, AND EXPENSES WHIHC MAY ARIES OUT OF OR IN CONNECTION WITH THE USE OF SUCH FACILITIES, INCLUDING WITHOUT LIMITATIONS, ALL CLAIMS I MIGHT HAVE FOR PERSONAL INJURY OR PROPERTY DAMAGE TO MYSELF OR SO ARISING. I UNDERSTAND THAT SWIMMING IS A PARTICIPATION SPORT AND I AM FULLY AWARE OF THE RISKS AND HAZARDS IN OR ARISING FROM MY USE OR PRESENCE UPON THE FACILITIES. I UNDERSTAND THAT I MUST CARRY MY OWN PERSONAL MEDICAL INSURANCE. I ALSO GIVE CONSENT TO RECEIVE FIRST AID AND EMERGENCY TRANSPORT TO THE NEAREST MEDICAL FACILITY.

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