Fillable Assumption of Risk and Release of Liability health (University of Hawaii at Hilo)

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Assumption of Risk and Release of Liability health (University of Hawaii at Hilo)

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Assumption of Risk and Release of Liability
Team Sports & Group Activities
Sport or Activity___________________
Team Name_________________________
1. I voluntarily desire to participate in Intramural Sports and Intramural Open Recreation
. I
u
nderstand that
I
2. I h
ave 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 t
o myself or others.
4. I have read and fully understand the written safety and others rule and precautions that are
a
p
art of the requirement for my participation in the above referenced sport/activity, as w
ell as
tho
se 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 insid
e
sport
/activity.
5. I have reviewed the Intramural eligibility rules and I am currently affiliated with University o
f
H
awaii-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 damag
e
ari
sing 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.
Team Members
1 Print Name:
Signature:
Email:
Phone:
Student ID #:
2 Print Name:
Signature:
Email:
Phone:
Student ID #:
3 Print Name:
Signature:
Email:
Phone:
Student ID #:
4 Print Name:
Signature:
Email:
Phone:
Student ID #:
5 Print Name:
Signature:
Email:
Phone:
Student ID#:
6 Print Name:
Signature:
Email:
Phone:
Student ID#:
7 Print Name:
Signature:
Email:
Phone:
Student ID #:
8 Print Name:
Signature:
Email:
Phone:
Student ID#:
Please use a second waiver form if you have more 8 team members.
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Assumption of Risk and Release of Liability health (University of Hawaii at Hilo)

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Completed 29 August 2020

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