CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO
CSUSB RECREATIONAL SPORTS
ASSUMPTION OF RISK, WAIVER, AND
RELEASE FROM LIABILITY
DRAFT
In consideration of the use of the property, facilities
and/or services of CSUSB Recreational Sports (Rec Sports) or any AUXILIARY
ORGANIZATIONS (Auxiliaries) participating or sponsoring Recreational Sports
Programs, including travel related thereto, the undersigned agrees as follows:
-
RISK FACTORS: The undersigned understands and
acknowledges that the use of equipment, facilities and services provided by
the University Recreation Programs (intramural, sport clubs, physical
sports, weight and cardiovascular training, dance, aerobics, swimming, and
any other programs and services sponsored by CSUSB Recreational Sports or
its associated Auxiliaries) involves risks such as, but not limited to, the
following which might result from the use of equipment or facilities, from
the activity itself, from the acts of others, or from the unavailability of
emergency or emergency medical care. RISK OF PROPERTY DAMAGE,
BODILY INJURY, AND POSSIBLE DEATH.
-
ASSUMPTION OF RISK. The undersigned ASSUMES
ALL RISKS THAT ARISE OUT OF THE USE OF THE EQUIPMENT OR FACILITIES, THE
ACTIVITY ITSELF, THE ACT OF OTHERS, OR THE UNAVAILABILITY OF EMERGENCY CARE,
including but not limited to, those RISK FACTORS described in section
1 above.
-
ACKNOWLEDGMENT OF POLICIES AND PROCEDURES. The
undersigned acknowledges reading and knowing all of the policies and
procedures relating to the activities, facilities, and/or equipment and
understands that the safe and proper use of the facilities, equipment or
participation in the activity is dependent upon carefully following such
policies and procedures.
-
PREREQUISITE SKILLS AND TRAINING. The
undersigned acknowledges that he or she has the requisite skills,
qualifications, physical abilities, and training necessary for proper and
safe use of the equipment and facilities and to participate in the activity
itself. The undersigned agrees that if he or she has any questions as
to what skills, qualifications or training is necessary to properly use the
equipment, facility, or to participate in the activity itself, then they
shall direct such questions to the appropriate staff member on site.
Items 1-4:
(Initials)
-
RELEASE. The undersigned RELEASES the
State of California, Trustees of the California State University, California
State University, San Bernardino, the University's Auxiliary organizations,
the officers, employees and agents of each and agrees NOT TO SUE them
on account of or in conjunction with any claims, causes of action, injuries,
damage, cost of expenses arising out of the activity, including those based
on death, bodily injury or property damage whether or not caused by the
acts, omissions or other fault of the parties being released.
-
WAIVER. The undersigned waives the protection
afforded by any statute or law in any jurisdiction including California Code
1542 whose purpose, substance, and/or effect is to provide that a general
release shall not extend to claims, material or otherwise which the person
giving the release does not know of or suspect at the time of executing the
release. This means, in part, that the undersigned is releasing
unknown future claims.
-
INDEMNIFY AND DEFEND. The undersigned agrees to
INDEMNIFY AND DEFEND the State of California, Trustees of the
California State University, California State University, San Bernardino,
the University's auxiliary organizations, the officers, employees and agents
(hereinafter jointly referred to as "indemnitee") of each against,
and hold them harmless from any or all claims, causes of action, damage
judgments, costs or expenses, including attorney fees which in any way arise
from the activity or this agreement which include but are not limited to
damages to or destruction of any property of the indemnitee, of any others,
injury or death of the undersigned or anyone else or any liability arising
from the act or negligent act of the indemnitee, the undersigned or anyone
else.
ITEMS 5-7:
(Initials)
-
PAY. The undersigned agrees to pay for any or
all damages to any property or indemnitee caused by the undersigned either
negligently, willfully, or otherwise.
-
REPRESENTATIVES. The undersigned enters into
this agreement for himself/herself, his/her heirs, assigns and legal
representatives.
-
EMERGENCY TREATMENT CONSENT. The undersigned,
as a participant in the subject activity, hereby consents to medical
treatment in a medical emergency where the undersigned is unable to consent
to such treatment.
-
INSURANCE. The undersigned understands that the
University and its auxiliaries do not carry participant insurance. The
undersigned is encouraged to have a physical examination and to purchase
health insurance prior to any and all participation.
Items 8-11:
(Initials)
-
ACKNOWLEDGMENT. The undersigned has read and
understands this agreement and realizes it relates to surrendering
valuable legal rights and does so freely and voluntarily.
Item 12:
(Initials)
Signature:
Date:
Staff Initials:
CONSENT AND RELEASE ON BEHALF OF MINOR
I am the parent and/or legal guardian of the above named
minor. I have read and understand the agreement involves surrendering
valuable legal rights of the minor and myself. I agree to be bound by all
terms of this agreement. I also give my consent to the participation in
the activity of the minor.
Date:
Signature of Parent/Legal Guardian - Consent and Release on
Behalf of the Minor
EMERGENCY CONTACT INFORMATION:
NAME
ADDRESS
CITY
STATE
ZIP
TELEPHONE
[Return to CSUSB
Recreational Sports Liability Release Procedure]
|