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Intramural Sports and Open Recreation (University of Hawaii at Hilo)

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SportorActivity______________________________
TeamName:________________________________
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.
TheundersigningthatIhavereadthisassumptionofriskandreleaseofliabilityandconsentknowingly
andvoluntarily.
TeamCaptain:______________________________ Cell:_____________________________
TeamCaptainemail:____________________________________
Name Email ShirtSize StudentID
Intramural Sports and Open Recreation
AssumptionsofRiskandReleaseofLiability
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Intramural Sports and Open Recreation (University of Hawaii at Hilo)

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Completed 29 August 2020

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