Registration Form

Registration Form

Waiver

Wallaceburg Adult Activity Club has the right to refuse membership to any individual or group. Members must remain in good standing; meaning adherence to the behavior standards set out by the Centre’s Code of Conduct Policy (#2-2) and all other Centre policies. Disciplinary actions will proceed as outlined in the Policy
I and anyone claiming on my behalf release and forever discharge Wallaceburg Senior Citizens Club Inc. (also known as the Wallaceburg Adult Activity Club), and its affiliates, successors and assigns, officers, employees, volunteers, representatives, partners, agents and anyone claiming through them (collectively, the Centre), in their individual and/or corporate capacities from causes of action of any nature and kind, known or unknown, which I may have against the Centre or any Released Parties arising out of or relating to any injury, loss or damage to person and property that may be sustained as a result of participation in the Activity (“Claims”).
I understand that participation in programs and activities involves inherent risks, including risk of physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent paralysis and/or death, and I assume all related risks and voluntarily participate in these programs and activities.
I agree to indemnify the Centre against any and all claims, actions, lawsuits, damages and judgments, including attorney’s fees, arising out of or relating to my participation in the Activity.
This Release for Participation in Event or Activity (“Release”) shall not be in any way construed as an admission by the Centre that it has acted wrongfully with respect to me or any other person, that it admits liability or responsibility at any time for any purpose, or that I have any rights whatsoever against the Centre.
I agree to comply with all COVID-19 protocols as set by the Centre, including but not limited to social distancing, sanitization, masking, and vaccination. I agree to not attend the Centre or any Centre hosted program or activity if I am experiencing any symptoms of COVID-19. I also release the Centre from any responsibility in the event that I contract COVID-19 at any Centre-sponsored activity.

Annual Membership Fee

Personal Information

Safety Information

Demographic Information (Optional)

Waiver

Visit the Wallaceburg Adult Activity Centre.
We are open Mon - Fri: 8:30am - 5:30pm

Registration Form

Page Content

Annual Membership Fee

Personal Information

Safety Information

Demographic Information (Optional)

Waiver

Visit the Wallaceburg Adult Activity Centre. We are open Mon - Fri: 8:30am - 5:30pm

Visit the Wallaceburg Adult Activity Centre.
We are open Mon - Fri: 8:30am - 5:30pm