Guest Waiver Form

This form must be filled out by an adult 18 years of age or older All guests must have a waiver. If you are a member of the pool a waiver is not required.

Event Number

If this is for a party, please enter the Event Number. The party host can give this to you.

Your Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Agreement(Required)

You MUST scroll through the Agreement

All members of PWIA, their families and their guests who enter or use the pool facility shall do so at their own discretion, risk, and responsibility. Members and guests will be solely responsible for all actions of themselves, their children, and their guests. PWIA assumes no responsibility whatsoever for any injury sustained in connection with use of the pool facility and assumes no responsibility for loss or damage of personal property of any kind. Persons using the pool facility understand and agree that negligent use of a pool and negligent parental supervision of children using any swimming pool can be inherently dangerous. In consideration of their use of the pool, members and guests agree to waive any and all claims and causes of action against PWIA and further agree to hold PWIA harmless from liability for any injury, death, or damages which may result from the use of the pool facility.
PWIA will strive to have a sufficient number of trained and certified lifeguards present at the pool facility during regularly scheduled hours to provide a safe environment within which members, their children, and their guests may enjoy the use of the pool. However, no members or guests should substitute the divided attention of lifeguard staff for their own best judgment and attention to the needs and safety of their children and guests.
All members, on behalf of themselves and their families, and all guests will be required to certify that they have read and will abide by the rules, regulations, and policies of PWIA prior to their initial use of the pool facility. On behalf of my family, my guests, and myself, I certify that we have read the foregoing Certification of Responsibility prior to our initial use of the pool facility and will abide by and promote the rules, regulations, and policies of PWIA.

I Agree

All minors that you have legal custody over must be listed. All adults including yourself must be listed. If the name is not listed, they will not be allowed into the facilities.

Guest Information(Required)

First Name

Last Name

Date of Birth (under 18)