Housing and Residence Life 300 College Park, Dayton, OH 45469-0950 937-229-3317 (phone)
937-229-3446 (fax) housing@udayton.edu
www.housing.udayton.edu
Housing and Residence Life
Student Development
Housing and Residence Life Minor Waiver
All minors 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