I, the undersigned, as the parent or legal guardian, agree to allow my child(ren) to participate in swimming lessons with SWIM TO LIVE, and its subsidiaries, divisions, affiliates, shareholders, officers, and employees (collectively, the "Company and its Representatives") from all claims, causes of action, or any other demands, which I, or my child, ever had, may have now or have at any time in the future, caused by, or arising out of , any alleged duty, connected with or related to activities occurring while my child is participating in swimming lessons at SWIM TO LIVE, or with Kassy Clifford, 4320 Miller Oak Drive, Auburn, CA 95602. And/or that may occur as a result of the use of any of the area. Make Up Policy: Please Initial: Please Initial: Medical History: Please Initial: I agree to indemnify and hold harmless the Company and its Representatives from and against any and all actual or threatened losses, liabilities (including liability, for personal injury or death), claims, damages, obligations, additional payments, costs and expenses, however caused and on any theory of liability, whether brought directly, derivatively, in contract, strict liability, statutory liability, common law liability, or tort arising out of, or relating to, my child(ren)’s participation in the swimming lessons provided by Kassy Clifford, and SWIM TO LIVE SWIM SCHOOL. I have noted on this form all relevant medical history, or medical problems of significance, pertaining to each child. I understand and agree that my child must always be under the supervision of a responsible adult any time he/she is near or around water. Additionally, I understand and agree that the lessons provided by Kassy Clifford and SWIM TO LIVE, do not imply or make any guarantee whatsoever of the water safety of my child(ren) and his/her ability to swim.