Minor Release Form

User Age and Use Restrictions – Swimming Pool

To ensure the safety of all users, the following age and supervision requirements apply to the community swimming pool:

Individuals under the age of 18 must be accompanied by a parent, legal guardian, or another authorized adult age 18 or older, as listed on the User Information Form.
Children ages 16-17 may use the pool without adult supervision if a current, signed Minor Release Form is on file. They may bring one guest without an adult present.
Youth ages 13–15 may use the pool without adult supervision if a current, signed Minor Release Form is on file. They may not bring a guest without an adult present.
Children age 12 and under may be accompanied by a supervising adult.
Children ages 6 and under must remain within arm’s reach of an adult (18+)

I affirm that I am the parent or legal guardian of the following minors between the ages of 12 and 17.

Name of Parent or Guardian

Property Address

Name/Age/Birthdate Minor 1

Name/Age/Birthdate Minor 2

Name/Age/Birthdate Minor 3

Name/Age/Birthdate Minor 4

Please list all guardians who are authorized to supervise minors:

By authorizing a minor to use the Riverdale Dunes Pool without direct adult supervision, the parent or legal guardian acknowledges and agrees that all activities engaged in by the minor at the pool are undertaken at the minor's own risk. The pool may not be supervised by a lifeguard or other attendant at all times. The District shall not be liable for any injuries, damages, claims, or losses incurred by the minor while using the pool facilities, regardless of the cause, including the actions or omissions of the District, its agents, employees, contractors, or representatives. The District reserves the right to revoke a minor's privilege to use the pool without adult supervision at any time if the minor fails to comply with District rules, regulations, policies, or otherwise engages in unsafe or inappropriate conduct while using the facility. Parents and guardians are responsible for ensuring that minors understand and follow all pool rules and safety requirements.

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