FAIRFIELD ATHLETIC CLUB

							                            FAIRFIELD ATHLETIC CLUB
                        GUEST HOLD HARMLESS AGREEMENT

I, ____________________________, am a guest of a member of Fairfield Village Community
Association, Inc., (“the Association”) who desires to use various recreational facilities owned by
the Association. I acknowledge that Fairfield Fitness Center, Inc. manages the recreational
facilities for the Association. I also acknowledge that agents and employees of Fairfield Fitness
Center, Inc. provide instructions regarding the use of equipment available at the facilities, but
such agents and employees are not trained to evaluate whether I am suitable or fit to use any such
equipment or to determine what level of physical exertion may be appropriate for me. I am not
relying upon Fairfield Fitness Center, Inc. or any of its agents or employees for any purpose with
regard to whether I am in appropriate physical condition to use any equipment at the facilities or
to engage in any type of exercise at the facilities. I agree to hold Fairfield Village Community
Association, Inc. and Fairfield Fitness Center, Inc., their respective officers, directors, agents and
employees, harmless from and against any and all claims for injuries to myself resulting from my
use of any of the recreational facilities of the Association, specifically including, without
limitation, the use of the diving boards at the swimming pool. I hereby affirm that I have read
and fully understand this Hold Harmless Agreement and that I am 18 years of age or older.

                                                    GUEST
                                                      Signature:___________________________

                                                      Print Name:__________________________

                                                      Date:_______________________________

                                                      Phone No.:__________________________
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 By signing this document, I acknowledge and agree that I will be responsible for the conduct
     of my guest and any damages to the facility and/or the equipment that results from any
     actions of my guest.
 I further hereby affirm that I am 18 years of age or older.

                                                      *MEMBER
                                                      Signature:___________________________

                                                      Print Name:__________________________

                                                      Address:____________________________

                                                      Phone No:___________________________

NOTE: Member and guest are required to provide identification to confirm age.