WELLNESS & FITNESS FACILITY
RELEASE, WAIVER OF LIABILITY, AND INDEMNIFICATION AGREEMENT
In consideration for ConocoPhillips Company allowing my and/or my minor’s use of the ConocoPhillips Wellness-Fitness Facility, its exercise programs, activities, and other services (collectively Facility), I, the undersigned, fully understand and agree to assume the sole risk of such use. Accordingly, I, on behalf of myself, spouse, heirs, estate, and assigns, expressly agree to release and hold harmless ConocoPhillips Company, and any of its present, former, or future subsidiaries, divisions, and affiliates, and its and their
respective directors, officers, employees, contractors, agents, heirs, legal successors and assigns (collectively Released Parties) from and against any and all claims, suits, demands, losses, damages, expenses, or liability arising under any cause, or claimed under any theory of law, that may arise from any property damage or loss, injury, illness, or death, including that which may result to me and/or my
minor, during or arising in any way from my and/or my minor’s use of the Facility, including but not limited to, any such claims arising from the negligence (whether active or passive, sole or concurrent) of any of the Released Parties.
I understand and agree that it is my responsibility to assess the hazards presented by use of the Facility, and further agree that I am the ultimate judge as to whether I and/or my minor can use the Facility without risk or injury to ourselves.
If a medical clearance must be obtained prior to my and/or my minor’s use of the Facility, I agree to consult a physician and obtain written permission prior to use of the Facility.
I agree that I am responsible for monitoring my and my minor’s condition during use of the Facility, and if any symptoms occur, my minor or I will cease such use and seek assistance immediately.
I understand that use of the Facility is voluntary and is not a requirement of ConocoPhillips Company.
By signing this Release and Waiver of Liability, I affirm that I have read this form in its entirety, that I understand its content, and that I am signing it voluntarily. I also affirm that my questions regarding the Facility have been answered to my satisfaction.
Participant Classification
____________________________________________________ _____Employee
Printed Full Name of Participant over age 18 (First, Middle, Last) _____Employee Spouse
_____Dependent Over Age 18
_____Minor Dependent
____________________________________________________ _____Retired Employee
Signature of Participant over age 18 _____Retiree Spouse/Dependent
_____COP Visiting
________________________________ _____Guest
Date _____Other:_______________
Indemnification for Minor Participants: The undersigned parent or guardian further agrees to indemnify, save and hold harmless the
Released Parties from and against any and all claims, suits, demands, losses, damages, expenses, or liability arising under any cause,
or claimed under any theory of law, that may arise from any property damage or loss, injury, illness, or death, that may brought, alleged,
or incurred by or on behalf of the minor and during or arising in any way from the minor’s use of the Facility, including but not limited to,
any such claims arising from the negligence(whether active or passive, sole or concurrent) of any of the Released Parties.
__________________________________________________________
Printed Full Name of Minor Participant (First, Middle, Last)
__________________________________________________________
Signature of Parent or Guardian (required if Participant is under age 18)
_______________________________
Date
Bartlesville Safety Compliance
Wellness-Fitness Services Safety/Emergency Procedures
Safety is a high priority at ConocoPhillips, and the Wellness-Fitness Services group encourages everyone to practice good safety habits at all times while using the facilities and equipment. It also is recommended that all participants consult with their physician before starting an exercise program.
The Wellness-Fitness Services staff is trained in first aid, CPR, AED (automatic external defibrillator) and oxygen use. AED equipment is available for use by any trained person.
The downtown ConocoPhillips emergency phone number is 1-6789.
Be prepared to provide your name, nature and exact location of the emergency, number of victims and their condition.
If you are outside the ConocoPhillips complex and need to report an emergency, call 911.
Medical Emergencies
If you experience any pain, discomfort or tightness in the chest, neck, back jaw or arms, nausea, shortness of breath, dizziness or light headedness and unusual fatigue during activity, stop exercising and notify the Wellness-Fitness Services staff immediately.
In the event of any emergency within the ConocoPhillips downtown Wellness-Fitness Services facility, contact the nearest Wellness-Fitness Services staff or security guard.
Fire: Activate the fire alarms located throughout the facility. Call 1-6789. Alert others in the area. Do not use elevators. Do not attempt to fight the fire. Follow the facility evacuation process posted in the facility.
Severe weather: Follow the facility evacuation process to a safe location – preferably the basement level. Stay away from windows and heavy equipment. Evacuation and safe areas are posted in the facility.
General Facility Safety
Walk, don’t run; use closed containers for transporting beverages, no glass containers, report any spills to the staff; respect others, no horseplay, foul language and/or gestures.
Locker Rooms: keep locker doors closed when not in use, use caution in tile areas – wet floors may be slippery, and read operating instructions before using the swimsuit spinners.
Aquatic Center: children age 6 and under must be accompanied by an adult in the water, do not enter the water unless there is a certified lifeguard on deck, use caution on tile deck – may be slick at times, notify lifeguards if assistance is needed entering or exiting the pool, and follow all pool rules posted in the aquatic area.
Gymnasium: use good sportsmanship at all times, play safe, do not hang on basketball rims or hang over railings, keep personal items off gym floor to avoid tripping and slipping and do not pull or hang on court dividers.
I have read and understand the Bartlesville Safety Compliance.
___________________________________________________
Printed Full Name of Participant over age 18 (First, Middle, Last)
____________________________________________________
Signature of Participant over age 18
_______________________________
Date