Assumption of Risk and Release of Liability
Individual Sports or Events
Sport or Activity___________________ Name_________________________
1. I voluntarily desire to participate in Intramural Sports and Intramural Open Recreation. I
understand that I
2. I have been encouraged to procure insurance which provide for general medical
benefits and health and accident coverage for injury or loss I may occur.
3. Prior to physical activity, I should check with my doctor(s) to ensure that participation
will not be a risk to myself or others.
4. I have read and fully understand the written safety and others rule and precautions that
are a part of the requirement for my participation in the above referenced
sport/activity, as well as those explained to me by the University of Hawaii-Hilo, its
officers, agents, and employees from any and all claims of actions for property damage,
and/or personal injury which may result from my failure to abide by these safety rules
and precautions or from any inherent risk inside sport/activity.
5. I have reviewed the Intramural eligibility rules and I am currently affiliated with
University of Hawaii-Hilo and have signed to this official team entry/roster or open
recreation check-in form prior to participation in the program.
6. I am aware that the activity is a dangerous activity and that I may suffer bodily or other
damage arising out of participation in the activity, including travel to and from it.
The undersigned have read this assumption of risk and release of liability and consent
knowingly and voluntarily.
Please circle your level of experience below:
First Time For Fun High School College
1 Print Name:
Signature:
Email: Phone:
Student ID #:
