Parent/Legal Guardian Acknowledgment

Parental or Guardian Consent Form of David Gribneau Enterprises Inc. dba Claytonís Cottages Located at #3 Seventh Lake Road, Inlet, NY 13360

Dear Parent or Legal Guardian: 
We have received a request by one of our tenants to bring your child(ren) to our lakefront property for a stay.   Please be advised of the following conditions:  We require a medical release form accompany the child in the event of an emergency in your absence as well as this form returned completed, signed and dated designating a responsible adult who will supervise the child(ren).  We do not advertise or provide a Lifeguard at the swimming/bathing area and no day care services or supervision of minor children are provided by the property management or operators.   We can not allow unsupervised children on the premises unattended and do not agree to permit or allow children without a parent or legal guardian, unless the parent or guardian designates a responsible adult who will be responsible for the supervision of that child or those children.  In consideration of bringing your child(ren) to the property the tenant who is making this request is solely responsible for the supervision of the child(ren) while he/she/or they are using the swimming/bathing area or any where on our property.  We can not accept this responsibility while a minor child is visiting here without his/her/their parent or legal guardian:  Listed are New York State Health Department Regulations and management policies which are required by all visitors to the property.

NO LIFEGUARD ON DUTY, SWIM AT YOUR OWN RISK.  NEVER SWIM ALONE.  A minimum of two adults, 18 years of age or older must be at the lakefront whenever the bathing area or swimming docks are used.  THERE IS NO SUBSTITUTE FOR ADEQUATE SUPERVISION OF YOUNG CHILDREN.  A parent or guardian must accompany children under 18 years of age.  Life jackets are advised for children and non-swimmers, but are not adequate without adult supervision as well.  DO NOT DRINK OR USE DRUGS AND SWIM or while supervising children.  IN CASE OF EMERGENCY: USE PAY PHONE, Office phone or phone at Drakeís Inn - ASK OPERATOR FOR INLET POLICE OR DIAL 911 or 357-5091 FOR ANY EMERGENCY.  (MEDICAL, FIRE, POLICE etc.)  Notify the Office.

RESCUE EQUIPMENT LOCATED on both sides of beach and inside wooden bench on lakeside deck.

ONLY REGISTERED GUESTS MAY USE THE SWIMMING AREA.  This is not a public beach; Day Visitors & Guests may not swim here.  To permit this requires a Lifeguard which would raise rental rates substantially for our tenants.  SWIMMING PERMITTED only during posted hours of operation. NO SWIMMING AT NIGHT.

All inflatables are considered watercraft when OUTSIDE OF A DESIGNATED SWIMMING AREA and the use of U.S.C.G. approved LIFEJACKETS is REQUIRED.  Owners of any watercraft are responsible to provide approved lifejacket for use in any watercraft, including inflatables, if used outside the swimming area.

OUR BOATS must be CHECKED OUT with the OFFICE, and require compliance with safety rules, and at least 1 ADULT user, and correctly fitting LIFE JACKETS FOR ALL USERS.  CHILDREN 12 and under AND NON-SWIMMERS MUST WEAR LIFE JACKETS in boats or watercraft as required under NYS Law.

ALL OVERNIGHT GUESTS, visitors or occupants, MUST BE REGISTERED WITH OFFICE BY 9 P.M. ARRIVAL DATE.  Fire and Health Dept. Codes.  Children age 14 years and under, must wear helmets when using a bicycle, roller blades, skateboard, scooter or similar device while on the premises.

I have read, understand and agree that the responsible adult named here will be responsible for the supervision of my child(ren)  while using our swimming/bathing beach or any where on our property.

Print the Adultís Name Responsible for Supervision of Child(ren):___________________________________

Signature of the Adult designated for supervision of Child(ren):_____________________________________

Print the Names of all Children to be supervised by this adult:______________________________________

Parent or Legal Guardianís Printed Name: ______________________________________________________

Parent or Legal Guardianís Signature: _____________________________________________Date:________

This form must be completed and signed prior to arrival to permit the above child(ren) to utilize our swimming/bathing area under the stated adult supervision while on our property.   Thank you.