OKLAHOMA CHRISTIAN UNIVERSITY, RELEASE AND WAIVER, PAGE 1 OF 2
RELEASE FROM RESPONSIBILITY, ASSUMPTION OF RISK, AND
WAIVER
READ THIS DOCUMENT COMPLETELY BEFORE SIGNING. ITS EFFECT IS TO RELEASE
OKLAHOMA CHRISTIAN UNIVERSITY, ITS EMPLOYEES, OFFICERS AND GOVERNING
BOARD FROM ANY LIABILITY RESULTING FROM YOUR PARTICIPATION IN THE
ACTIVITIES DESCRIBED BELOW, AND TO WAIVE ALL CLAIMS FOR DAMAGES OR LOSSES
AGAINST THE UNIVERSITY WHICH MAY ARISE FROM SUCH ACTIVITIES.
PARTICIPANT’S FULL NAME: _______________________________________________________________
DATE OF BIRTH (MO/DAY/YR): ______________________________________________________________
ADDRESS: __________________________________________________________________________________
LOCATION
OF ACTIVITY(IES): ______________________________________________________________
DATE(S) OF ACTIVITY(IES): START DATE: _____________________ END DATE: ________________
Check one: STUDENT OR NON-STUDENT
DESCRIPTION OF ACTIVITIES:
INSURANCE INFORMATION:
IF STUDENT: I am aware that as a student of Oklahoma Christian University, I can purchase
accident insurance, either through Oklahoma Christian University or through an insurance carrier
or agent, and (check one) have have not exercised my right to do so.
NAME OF INSURANCE CARRIER: _______________________________________
POLICY NUMBER: _____________________________________________________
I, the undersigned participant, exercising my own free choice to participate voluntarily in the above-
named activities, and promising to take due care during such participation, hereby release and discharge,
indemnify and hold harmless the University, and their members, officers, agents, employees, and any
other persons or entities acting on their behalf, and the successors and assigns for any and all of the
aforementioned persons and entities, against any and all claims, demands, and causes of action
whatsoever, whether presently known or unknown, either in law or in equity, relating to injury, disability,
death or other harm, to person or property or both, arising from my participation in and/or presence at the
above listed activities.
I acknowledge that I have been informed of the nature of the activities and that I am aware of the hazards
and risks which may be associated with my participation in the above-named activities, including the
risks of bodily injury, death or damage to property which may occur from known or unknown causes. I
understand, accept, and assume all such hazards and risks, and waive all claims against the University,
and other persons as set forth above. I understand that I am solely responsible for any costs arising out of
OKLAHOMA CHRISTIAN UNIVERSITY, RELEASE AND WAIVER, PAGE 2 OF 2
any bodily injury or property damage sustained through my participation in normal or unusual acts
associated with the above-named activities.
I have had sufficient time to review and seek explanation of the provisions contained above, have
carefully read them, understand them fully, and agree to be bound by them. After careful deliberation, I
voluntarily give my consent and agree to this Release From Responsibility, Assumption of Risk, and
Waiver.
READ, UNDERSTOOD AND AGREED TO THIS DAY OF , 20 .
Signature of Participant whose printed name appears above:
Signature Witness over 18 years of age (Participant must
sign in the presence of the Witness)
If participant is under the age of 18, his or her parent or legal guardian must also sign:
I, (printed name) ________________________________________________, am the parent or legal
guardian of the participant who has signed above. I have read and I understand the provisions of this
document, I consent to the participant taking part in the activities described above, and I fully enter into
and agree to the above Release From Responsibility, Assumption of Risk, and Waiver.
Signature of Parent or Legal Guardian (date) Witness over 18 years of age (Parent or
Guardian must sign in the presence of the
Witness)
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