I understand that by submitting this form, I am registering myself for admission to Splash Class for $25 to be paid in cash or check prior to or on the first day of class. As a participant in Splash Class, I grant the City of Lynchburg permission to use my likeness and name in any communication materials. Materials may include but are not limited to news releases, publications, billboards, television, and web use.

The Lynchburg Water Resources Department is allowing my child and/or me to participate in a tour of the College Hill Water Treatment Plant and the Lynchburg Regional Water Resource Recovery Facility. I acknowledge that the tour will include areas of the facility where water is treated and related industrial activities occur. As a condition of being allowed to participate in the tour, my child and/or I agree to follow all safety rules and procedures and obey all instructions of the tour leader. Failure to follow safety rules or the tour leader’s instructions may result in personal injury and/or property damage. In consideration of being allowed to participate in the tour and understanding the risks that are associated with the tour, my child and/or I assume full responsibility for such risks and we agree that neither my child and/or I, our legal representatives, heirs or assigns, will hold the City of Lynchburg, its officials, employees or agents responsible for any injuries, disabilities, physical and mental diseases, death, property damage, or losses and expense of any nature whatsoever that my child and/or I may sustain as a result of our participation in the tour. Further, I agree to defend, hold harmless, and indemnify the City of Lynchburg and its officials, employees or agents, from and against any and all claims, losses, damages, injuries, fines, penalties, costs (including court costs and attorney's fees), charges, liability, or exposure, however caused, resulting from, arising out of, or in any way connected with the tour of the College Hill Water Treatment Plant and the Lynchburg Regional Water Resource Recovery Facility. This indemnification shall survive the time period of the visit to the site.