Housing and Residence Life Waiver
All minor visiting the University of Dayton Campus must abide by the Children on Campus; Working with Minors Policy.
I, as the parent or legal guardian of the child listed on this application, give permission for
my child to spend the night in University of Dayton housing and hereby assume full
responsibility for all risk of injury which may result from my child's participation in this
activity. I hereby hold harmless the University of Dayton, its employees and agents, from
any and all claims, demands, injuries, damages, actions, or causes of actions which arise,
regardless of whether such claims are based upon negligence or other grounds. I also
acknowledge that I will be financial responsible for any and all damage that may result from
the behavior of my child.
In case of an emergency and I cannot be reached, I authorize the staff of University of
Dayton, Housing and Residence Life, to obtain whatever medical treatment they deem
necessary for the welfare of my child listed on this application. I further understand and
agree that I will be financial responsible for all charges and fees.
Dependent’s Name: ______________________________________________
Parent / Guardian’s Name: _________________________________________
Parent / Guardian’s Email: _________________________________________
Parent / Guardian’s Contact Phone Number: ___________________________
Signature Date
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