Required paperwork
Medical Liability Waiver
Every swimmer needs this waiver and medical consent on file before entering the water. Read the full document, complete the medical details, and sign electronically — you'll get a PDF copy by email immediately.
Medical Liability Waiver, Release & Medical Consent
Effective August 1, 2026 · v1.0
1. Parties and Purpose
This Medical Liability Waiver, Release of Liability, Assumption of Risk and Medical Consent Agreement ("Agreement") is entered into between Swim with Clayy, a sole proprietorship operated by Clayton Reed ("Instructor," "we," "us"), and the parent or legal guardian identified below ("Parent"), on behalf of the minor swimmer identified below ("Swimmer").
This Agreement applies to all swim lessons, water-safety instruction, evaluations, make-up sessions, and related activities provided by Swim with Clayy at the Stacy Center in Princeton, Missouri, or at any other facility designated by Swim with Clayy.
2. Assumption of Risk
Parent understands that swimming, water-safety instruction, and all aquatic activities involve inherent risks that cannot be eliminated regardless of the care taken. These risks include, without limitation: slipping or falling on wet surfaces; collision with other swimmers, walls, lane lines, or equipment; muscle strains and orthopedic injury; ear, eye, sinus, and skin irritation; aspiration or ingestion of water; hyperventilation or shallow-water blackout; near-drowning; drowning; cardiac or respiratory events; and catastrophic injury, permanent disability, or death.
Parent knowingly and voluntarily assumes all such risks, both known and unknown, and accepts full responsibility for the Swimmer’s participation.
3. Medical Fitness and Disclosure
Parent represents that the Swimmer is physically and medically able to participate in swim instruction, and that Parent has disclosed on this form every allergy, medical condition, medication, seizure history, physical limitation, behavioral consideration, and any other health information relevant to safe participation.
Parent agrees to notify Swim with Clayy in writing of any change in the Swimmer’s health, medication, or medical condition before the Swimmer’s next lesson. Parent understands that incomplete or inaccurate medical information may endanger the Swimmer and that Swim with Clayy relies on the accuracy of the information provided.
4. Emergency Medical Consent
In the event of an accident, injury, or medical emergency, Parent authorizes Swim with Clayy and facility staff to administer first aid, CPR, and AED care as trained, and to summon emergency medical services. Parent consents to the Swimmer’s examination, treatment, and transport by licensed emergency medical personnel, physicians, and hospitals when Parent cannot be reached immediately.
Parent accepts financial responsibility for all costs of emergency care, ambulance transport, and medical treatment arising from the Swimmer’s participation, to the extent permitted by law.
5. Release and Waiver of Liability
To the fullest extent permitted by Missouri law, Parent, on behalf of Parent and the Swimmer, releases, waives, discharges, and covenants not to sue Swim with Clayy, Clayton Reed, and their agents, employees, volunteers, and facility hosts (collectively, "Released Parties") from any and all claims, demands, damages, causes of action, and liabilities of any kind arising out of or related to the Swimmer’s participation, including claims arising from the ordinary negligence of the Released Parties.
This release does not apply to gross negligence, recklessness, or intentional misconduct, nor to any liability that Missouri law does not permit to be released.
6. Indemnification
Parent agrees to indemnify, defend, and hold harmless the Released Parties from any loss, liability, damage, cost, or expense, including reasonable attorney fees, that they may incur as a result of the Swimmer’s participation or as a result of any inaccurate or incomplete medical information provided by Parent.
7. Instructor Qualifications and Supervision
Coach Clayton is CPR/AED and First Aid certified, holds a current Lifeguard Instructor credential, and has completed a background check. Parent understands that instruction is not a substitute for constant adult supervision and that no instruction can make any person "drown proof."
Parent agrees to remain on site and reachable for the duration of each lesson unless otherwise arranged in writing.
8. Rules, Health Screening, and Removal
Parent agrees that the Swimmer will follow all posted facility rules and all instructions given by the Instructor. Swimmers who are feverish, actively ill, contagious, or experiencing diarrhea, open wounds, or communicable skin conditions must not enter the water.
Swim with Clayy may end or decline a lesson for safety reasons, including unsafe behavior, undisclosed medical conditions, or facility conditions, without refund of that session where the lesson has begun.
9. Payment, Cancellation, and Photography
Payment is due at the first lesson, prior to entering the water, unless other arrangements are made in writing. Cancellation, make-up, and weather rules are described in the published Swim with Clayy lesson policies, which are incorporated by reference.
Photography or video of the Swimmer for promotional purposes is optional and handled by a separate photo release. Signing this Agreement grants no promotional media rights.
10. Governing Law, Severability, and Term
This Agreement is governed by the laws of the State of Missouri without regard to conflict-of-law principles. Venue for any dispute lies exclusively in the courts of Mercer County, Missouri.
If any provision of this Agreement is held unenforceable, the remaining provisions remain in full force. This Agreement remains in effect for all lessons and activities until revoked in writing by Parent, and continues to apply to activities that occurred before revocation.
11. Electronic Signature
Parent understands that this Agreement is signed electronically and that, under the federal E-SIGN Act (15 U.S.C. § 7001 et seq.) and the Missouri Uniform Electronic Transactions Act (§ 432.200 et seq., RSMo), an electronic signature has the same legal force and effect as a handwritten signature.
Parent acknowledges having read this entire Agreement, having had the opportunity to ask questions, and signing it freely and voluntarily on behalf of Parent and the Swimmer.
You have reached the end of the waiver. Complete the form below to sign.
