Fillable AssumptionsofRiskandReleaseofLiability FreeAgentContract 1. IvoluntarilydesiretoparticipateinIntramuralsportsandIntramuralOpenRec.IunderstandthatI amresponsibleforthefollowingoccurrences. 2. Ihavebeen

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AssumptionsofRiskandReleaseofLiability FreeAgentContract 1. IvoluntarilydesiretoparticipateinIntramuralsportsandIntramuralOpenRec.IunderstandthatI amresponsibleforthefollowingoccurrences. 2. Ihavebeenencouragedtoprocureinsurance,whichprovideforgeneralmedicalbenefitsand healthandaccidentcoverageforinjuryorlossImayoccur. (University of Hawaii at Hilo)

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AssumptionsofRiskandReleaseofLiability
FreeAgentContract
PrintName:portorActivity:______________________________ ________________________________S
1. IvoluntarilydesiretoparticipateinIntramuralsportsandIntramuralOpenRec.IunderstandthatI
amresponsibleforthefollowingoccurrences.
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othersandmyself.
4. Ihavereadandfullyunderstandthewrittensafetyandotherrules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of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.
heundersigningthatIhavereadthisassumptionofriskandreleaseofliabilityandconsentknowinglyT
andvoluntarily.
leasec velofexperiencebelow:P ircleyoule
FirstTime
ForFun
oolHighSch
StudentID#:
College
__ _______________________________Signature:__________________________________________
ShirtSize:Cell:email: ____________________________________ ___________________________________ ___________
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AssumptionsofRiskandReleaseofLiability FreeAgentContract 1. IvoluntarilydesiretoparticipateinIntramuralsportsandIntramuralOpenRec.IunderstandthatI amresponsibleforthefollowingoccurrences. 2. Ihavebeenencouragedtoprocureinsurance,whichprovideforgeneralmedi

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Completed 29 August 2020

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