LARAMIE COUNTY COMMUNITY COLLEGE
RECREATION & ATHLETIC CENTER LIABILITY WAIVER
Parcipant Name:
The above Parcipant being eighteen (18) in age or older, or the Parent of the above Parcipant, who
is under age eighteen (18) in consideraon for being allowed by Laramie County Community College
(LCCC) to use the LCCC Recreaon & Athlec Center climbing wall located on the Cheyenne Campus,
and/or parcipate in programs or classes oered by LCCC ulizing the aforemenoned PE Building
Facility agrees as follows:
Parcipant acknowledges and is aware of the inherent risks, hazards and dangers of personal injury,
death and disability in the use of climbing wall, exercise equipment or exercising in the Facility.
Parcipant also understands that these risks, hazards and dangers are further increased when other
persons are using the same Facility.
Parcipant acknowledges that parcipaon in any programs or classes oered by LCCC ulizing
the Facility is strictly voluntary and despite the dangers which are an integral part of the Facility,
Parcipant chooses to voluntarily use the Facility; and/or parcipate in any programs or classes
oered by LCCC ulizing the Facility.
Parcipant ceres that he/she has read the LCCC safety rules regarding the Facility, and agrees
to abide by the rules and any further amendments. Parcipant agrees to comply with any specic
instrucon or request given by LCCC sta.·
I hereby cerfy that I am over 18 years of age or the Parent of the above Parcipant, who is under
the age of 18. I have carefully read the foregoing and acknowledge that I understand and agree to all
of the above terms and condions. I have had the opportunity to ask any and all quesons regarding
this Waiver. I am aware that by signing this Waiver, I assume all risks and waive and release certain
substanal rights that I may have. I acknowledge that this Waiver/Agreement is binding upon myself,
my heirs, executors, administrators, and representaves in the event of my death or incapacity.
Parcipant’s Name:
Parcipant’s Parent’s Name (if applicable):
Address: City: ZIP:
Phone: Cell Phone: Email:
Emergency Contact: Phone:
As parent or legal guardian I hereby conrm I am the parent or guardian, acknowledge and
agree to the terms and condions of this certain waiver.
Signature of Parent or Legal Guardian of Minor Date
LARAMIE COUNTY COMMUNITY COLLEGE
RECREATION & ATHLETIC CENTER LIABILITY WAIVER
PRS 619 8/19
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