Assumption of Risk, Waiver, and Release from Liability (Minor) Logo
  • Assumption of Risk, Waiver, and Release from Liability (Minor)

    Recreational Sports & Services
  • ASSUMPTION OF RISK/AGREEMENT TO PARTICIPATE: I, * , as parent or legal guardian, hereby consent for my child, * , age,   * , to participate in activities and exercise programs at Southern Illinois University at Carbondale Student Recreation Center.

    I am aware that exercise, swimming, and/or the use of exercise equipment may involve a risk of personal injury or death. I hereby accept responsibility for any injury my child may incur. I do so on behalf of my child, myself, my spouse, other family members, heirs, assigns, and personal representatives. I further agree to hold harmless the Board of Trustees of Southern Illinois University, its employees and agents from any claims which may arise due to my child's participation at the SIU Recreation Center or for any first aid, emergency treatment, or services rendered. 

    I am aware that exercise, swimming, and/or the use of exercise equipment may involve a risk of personal injury or death. I hereby accept responsibility for any injury my child may incur. I do so on behalf of my child, myself, my spouse, other family members, heirs, assigns, and personal representatives. I further agree to hold harmless the Board of Trustees of Southern Illinois University, its employees and agents from any claims which may arise due to my child's participation at the SIU Recreation Center or for any first aid, emergency treatment, or services rendered. 

  •  - -
  •  - -
  • Clear
  • Clear
  • Should be Empty: