Redbird Challenge
2016-2017
Waiver of Liability, Assumption of Risk, and Indemnity Agreement
Waiver: In consideration of being permitted to participate in any way in theuse University resources while participating in (name of club) ______Sport Club (an independent Registered Student Organization) between August 22, 2016– August 20, 2017, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue the Board of Trustees of Illinois State University, its officers, employees, agents and assigns, all participating event sponsors and volunteers or officials from liability from any and all claims including those which result in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, my participation in this programSport Club and/or the use of University resources associated with this activity.
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Signature of Participant Date Parent/Guardian Signature if Participant
Is a Minor (Under 18)
Assumption of Risks: Participation inUse of University resources for participation in this Sport Club Program and/or the use of University resources associated with this activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as bruises, sprains, floor burns, and soreness to 2) major injuries such as pulled muscles, broken bones, and fractures.
I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the use of University resources for participation in this Sport Club Program and its events. I hereby assert that my participation is voluntary, I do not have any medical/physical limitations that might hinder my participation in this eventSports Club or use of University resources, and I knowingly assume all such risks. If I require medical attention as a result of my participation in this event, I hereby give consent to authorize medical personnel to provide such medical care as deemed necessary. I understand that I am responsible for the payment of any and all medical care costs.
Indemnification and Hold Harmless: I also agree to indemnify and hold harmless The Board of Trustees of Illinois State University, from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, brought as a result of my involvement in this Sport Club Program and/or the use of University resources associated with this activity.
Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
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Signature of Participant Date Parent/Guardian Signature if Participant
Is a Minor (Under 18)
Participant Name University ID#
Phone ( ) - Email
EMERGENCY INFORMATION
In case of emergency, please contact Relationship
Cell ( ) - Home ( ) -
Updated 8/4/16
Approved 8/22?/16?
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