HOA Pool Device Agreement Form

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Please note: Only the owner of the property or the owner’s property manager can complete this agreement. Tenants cannot complete this agreement.


Where As

further known as the association and the

further known as the owner who’s property address is

Where as the association owns and operates a common facility, said facility is owned by the association and is for use by the owners, guests and residents.

Where as owners, guests and tenants may use the common facility.

Now therefor all parties abound hereto shall agree as follows.

Definition of the facility:

Clubhouse and related furniture and equipment, workout facility and related equipment, swimming pool and related furniture and equipment, playgrounds and related equipment, benches, walkways and any and all other surfaces or areas contained in the community and defined as a common element in the Declarations Covenants Conditions and Restrictions available for the use of all owner’s guest and tenants.

Assumption of Risk:

1. Use of the common facility is done at the risk of the person or persons utilizing the facility. Owners should be aware and shall make their guest aware of the hazards of using the common facility with reference to COVID -19 and all communicable disease. Owner(s) hereby agrees to communicate risk to all guest and/or residents living in the unit.

2. Users of the common facility are hereby made aware of the following risk.

  • The common facility has not been cleaned by a professional cleaning company certified in decontamination.
  • Use of the facility may result in the contraction of a communicable disease such as but not limited to COVID-19.
  • C. There may or may not be a monitor or lifeguard on duty in the facility. All facilities including but not limited to pools, tennis courts, playground ponds, lakes, walking trails, weight equipment or any and all other types of equipment in the community are to be used at the risk of the user of the facility.

3. Users of the facility shall be responsible for the cleaning of the area that they use either prior to use or after use of the facility and related equipment.

4. By signing this agreement, I acknowledge the contagious nature of COVID-19 and any other communicable disease and voluntarily assume the risk that my child(ren) and I as well as my guest and tenants may be exposed to or infected by COVID-19 or any other type of communicable disease, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19, or any other communicable illness may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the association its mangers and subcontractors.

5. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself spouse or life partner as well as my guest and tenants including, but not limited to, personal injury, disability, and death, illness, damage, loss, claim, liability, or expense, of any kind, that I my child(ren), guest and tenants may experience or incur in connection with use of the facility. On my behalf, and on behalf of my child(ren)s, guest, and tenants I hereby release, covenant not to sue, discharge, and hold harmless and indemnify the association, its employees, agents, sub-contractors, property managers and representatives, of and from the claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the association, its employees, agents, and representatives, whether a COVID-19or any other illness or infection occurs before, during, or after the use of the facility.

6. If applicable, the pool facility is swim at your own risk, no lifeguard is provided at the community at any time. Please review the pool rules for the pool facility prior to using the facility.

Key acceptance:

1. I hereby accept responsibility for the key to the common gate that services the amenity in the community. The person named above hereby agrees to pay any cost of a replacement key and programming for any lost, broken, or stolen key. The cost as of this agreement is $85.00 and is subject to change without notice. to the parties of this agreement. In the event my key becomes lost, stolen or broken I will within a reasonable amount of time notify the management company for the community.

2. Any pool key/fob activation or modification shall be done Monday to Friday excluding all National Holidays. The time frame for reprogramming a pool key is 5-7 working days. Working days shall be defined as Monday to Friday from 9:00 AM to 5:00 PM excluding all holidays. I further understand that there may be circumstances out of the control of the programmer that may affect the time frame stated herein and no liability for delays outside of the control of the key programmer.

3. I agree to be responsible for the actions of any person using the key further, I understand should my unit be sold that I agree to transfer the key to the new owner. Should I fail to transfer the key to any new owner, I agree to pay for the replacement of the key.

4.I agree to be responsible for conduct of myself and of any guest(s). Further, I agree to abide by any and all rules as posted at the facility. I agree to be responsible for the damage and conduct as a result of negligence on behalf of myself or guest(s). Should any damage occur to the facility due to willful misconduct or accident as a result of my actions or the actions of a guest, I understand that I will be responsible for the cost of any and all repair to facility this includes and is not limited to the cost of water and cleaning should a pool facility need to be drained and refiled. I further agree to abide by the request of the pool staff should a pool staff person be present at the time I visit the pool. However, I understand that pool staff facility member may not be present and is not required to be present at the time of the use of the pool facility. I understand the pool facility is to be used at the risk of the user of the facility and that no lifeguard or monitor is or may be on duty to provide any kind of lifesaving care.

5. I understand and agree that my pool privileges may be suspended at any time as a result of my actions or the actions of my guests, or a violation of any of the pool rules as stated in the attached document or as posted.

6. I understand that video surveillance equipment may or may not be used in the facility or on the common area of the community for the purpose of awareness of the use and condition of the property and areas of high traffic. I understand that the facility may or may not be monitored at any time. Further I understand that it is not up to the monitor of the video surveillance equipment to take any action in the event the camera views an illegal act or an act that may result in harm or death to any person. As a result, in the event that the surveillance equipment is in use I understand that my likeness and or image may be stored in conjunction with the HOA video surveillance policy. I agree to notify any and all guests or tenants that video surveillance equipment may be used for the purpose stated herein and the terms of the use of the equipment. I will further inform guests that the surveillance equipment may or may not be monitored at any time that the use of the equipment is not to ensure any safety of any type.

Legal jurisdiction:

1. The legal authority for this agreement shall be the laws of the state of Tennessee, if one or more parts of this agreement are shown to be unenforceable by law or by a court the other non-effected portions of the agreement shall survive the unenforceable portions.

2. No party to this agreement shall be deemed the owner of this agreement; all parties to this agreement have been provided an opportunity to review this document with their legal counsel and have entered the document fully understanding the terms as stated herein.

3. No alterations or changes can be made to this agreement unless you do so in writing.

4. No promise of any kind shall be made outside of this agreement.

5. Counterparts: This agreement may be executed in two or more counterparts, each of which shall be deemed an original but all of which shall together constitute one and the same instrument.

By placing my signature below, I state that the owner of the unit has signed and agrees to the terms in this device agreement. Let it also state that I have received the access device and that I will hold it in my possession for the below mentioned property. I agree to transfer the access device to the new owner if/when the property transfer’s ownership/position. I fully understand there is a replacement cost for this access device if damaged and/or lost.

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