Please fill all forms, print and sign.
Acknowledgement, Assumption of Waiver and Indemnification
Many programs, activities and workshops involve substantial risks of injury and other dangers associated with participation in such recreational activities. Dangers include but are not limited to: broken bones, sprains, bruises, concussion, and heart attack. Each participant using the Andrews Student Recreation and Wellness Center should realize that there are inherent risks, hazards and dangers involved with participating in a Campus Recreation program. It is the responsibility of each participant to engage only in activities for which he/ she have the prerequisite skills, qualifications and training. It is the participants’ responsibility to follow the instruction of the activity leader/ staff during the activity and or any emergencies. The participant is responsible for monitoring their own physical condition throughout the duration of this program and should cease participation if any unusual symptoms (such as but not limited to: shortness of breath, dizziness, cramps, dehydration, increase of heart rate, respiratory failure, cardiac arrest, stroke or other injury) occur.
In signing this consent form, I affirm that I have read the following notice carefully and understand the inherent risk of participating in a Campus Recreation program or use of a facility. I understand that the nature of this activity may involve certain dangers and risks, and I hereby voluntarily assume all risks of accident, damage or injury, including death, that I may sustain in any way from participating in the aforementioned activity. I, along with my family, heirs, and personal representatives do hereby release and forever discharge Youngstown State University, the Department of Campus Recreation and their agents and employees from any liability for personal injury, death, or property damage of any kind sustained in any manner arising or growing out of my participation in a Campus Recreation program. I agree to indemnify and hold harmless Youngstown State University from any and all claims, liability, loss and expense, including but not limited to damages, legal expenses and costs of defense, and any claims of any nature whatsoever, in any manner, arising from my participation in an Intramural Sports program.
Department of Campus Recreation program.