HERITAGE LANDING COMMUNITY DEVELOPMENT DISTRICT
Camp Heritage Amenity Facility Registration
Name of Home Owner(s) OR Tenant(s):
First Name	Last Name	First Name	Last Name
1. 	 		2.  	    	
List Others Living in the Home:
First Name	Last Name	Age	First Name	Last Name	Age

1. 	 	 		2.  	     	    	

3. 	 	 		4.  	     	    	

5. 	 	 		6.  	     	    	

Address:				 Contact Number: 	Additional Contact Number:  		                                                    E-Mail:  			 		 	
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Facility Access Card Numbers: (ONLY 2 Access Cards per Household)	 		 		
ACCEPTANCE:
I acknowledge receipt of the Facility Access Cards identified above. I further acknowledge the waiver as set forth below and agree to its terms. I have also been provided with, read, and agree to abide by the recreation center and pool guidelines as well as the guest policy. I also understand that I am financially responsible for any damages caused by me, my family members or my guests and for any damages resulting from the loss or theft of my Facility Access Card. I further understand that I am financially responsible for any damages caused by any person not related to me whom I allow to reside in my home by any formal or informal agreement and with whom I share my rights to access the amenity center facility by granting use of my Facility Access Cards. I agree to report to the Amenity Office any individuals resident in my home, whether related to me or not, in order that the Amenity Center can accurately keep track of the number of non-resident guests I bring to the Facility.

Signature of Home Owner or Tenant 		Date 		
GUEST POLICY:
Each property owning entity and non-resident fee paying entity is allowed one (1) set of 25 guest uses annually by the District at no cost. An Additional 25 guest allowance may be purchased for $42.50 at Camp Heritage.
Each guest counts as one (1) use with a max of four (4) guests per visit.
Resident must be present at the amenity center with guest(s) at all times. Guests may not be at the amenity center without a resident.	
The undersigned agrees and acknowledges that the above information is true and correct. It is understood that User cards are the property of the Heritage Landing Community Development District (HL-CDD) and are non-transferable except in accordance with the District’s rules, policies and/or regulations. In Consideration for the admittance of the above listed persons and their guests into the Camp Heritage facility owned and operated by the HL-CDD, the undersigned agrees to hold harmless and release the HL-CDD, its agents, officers and employees along with Vesta Property Services, its agents, officers and employees from any and all liability for any injuries that might occur in conjunction with usage of Camp Heritage ( including but not limited to: fitness rooms and equipment, swimming pools, tennis courts, volleyball courts, playground equipment, club house space). Nothing herein shall be considered as a waiver of the Districts sovereign immunity or limits of liability beyond any statutory limited waiver of immunity or limits of liability which may have been adopted by the Florida Legislature in Section 768.28 Florida Statutes or other statute.

Signature of Home Owner OR Tenant 		Date 		
FOR HOME OWNERS ONLY:
The undersigned, a home owner within the HL-CDD, agrees and acknowledges that it will not provide Facility Access Cards to any Tenant (as used herein, the term Tenant shall include all family members of the specifically named Tenant) without first providing a Camp Heritage Facility Registration Form (the “Registration”), executed by Tenant, to a Camp Heritage staff member. Should the undersigned provide Facility Access Cards to a Tenant without provid- ing a Camp Heritage staff member with a Registration signed by Tenant, the undersigned agrees to be financially responsible for any damages caused by Tenant and agrees to indemnify HL-CDD, its agents and Vesta Property Services, from any and all liability for any injuries that Tenant may sustain in con- junction with the usage of the Camp Heritage facilities. Nothing herein shall be considered as a waiver of the Districts sovereign immunity or limits of liability beyond any statutory limited waiver of immunity or limits of liability which may have been adopted by the Florida Legislature in Section 768.28 Florida Statutes or other statute.

Signature of Home Owner ONLY 		Date 		
OFFICE USE ONLY	Date Photo ID Verified 		Staff Member Initial  	
Date Received 		Date Entered in System 		Staff Member Signature  		
Replacement/Extra Card # 		Date 	Cash/Check # 		Staff Initial._