Lerner Wellness Center Annual Participation Agreement

Assumption of Risk and Release Form


This is a legally-binding Assumption of Risk and Release made by me, the reader, as participant, to Catawba College.

  1. I desire to participate in various activities ('the activities') made available at or through the Lerner Wellness Center ('Wellnes Center') during the current academic year. I fully recognize there are dangers and risks to which I may be exposed by participating in the activities, including traveling to and from the activities, which dangers and risks could result in personal injury, property damage and even death. I understand that I may engage in the activities without individual supervision or instruction, and that, in those circumstances where certain areas or activities may be monitored by Wellness Center staff employed by Catawba College, such personnel are not necessarily fitness professionals.
  2. I understand that the risks to which I may be exposed include, but are not limited to, such things as sickness, broken bones, sprains, concussions, injury from athletic equipment, heart attack and inclement weather. I further understand that I may be exposed to other risks that may not be foreseeable. I understand that the activities may involve coaches, officials, or instructors who are not employees or agents of the College.
  3. I understand that Catawba College does not require me to make use of the Wellness Center, but I want to do so, despite the possible dangers and risks and despite this Assumption of Risk and Release Form.
  4. I acknowledge that I have attended an orientation and training session regarding the activities made available through the Wellness Center (and the equipment and facilities used in or related to such activities). I further acknowledge that I have read a written statement of the Wellness Center Rules and Regulations, including a disclosure of risks related to use of the Wellness Center.
  5. In consideration of and in return for the services, facilities and other assistance provided to me by College in Lerner Wellness Center activities, and in consideration of being permitted to participate in the activities. I therefore agree, on behalf of my family, heirs and personal representative(s) to, to assume and take on all of risks and responsibilities in any way associated with the activities. To the maximum extent permitted by law, I release and indemnify Catawba College (and its governing board, officers, employees and agents) from any and all liability, claims and actions that may arise from injury or harm to me, from my death or from damage to my property in connection with the activities. I understand that this Assumption of Risk and Release Form covers liabilities, claims and actions caused entirely or in part by any acts or failures to act of Catawba College (or its governing board, officers, employees or agents), including but not limited to negligence, mistake or failure to supervise by Catawba College.
  6. I have consulted with a medical doctor with regard to my personal medical needs, and am aware of all applicable personal medical needs that may preclude or restrict my participation in the activities and I choose to participate.
  7. I further authorize the College to seek emergency medical treatment in connection with my participation in the activities and I acknowledge and agree that the College will assume no responsibility for, and shall be released from any claim or liability relating to, any injury or damage which might arise out of or in connection with such authorized emergency medical treatment.
  8. I recognize that this Assumption of Risk and Release means I am giving up, among other things, rights to sue Catawba College, its governing board, officers, employees and agents for injuries, damages or losses I may incur, including but not limited to costs, attorney’s fees and expenses, resulting from or in any way connected with my participation in the activities. I also understand that this Assumption of Risk and Release binds my heirs, executors, administrators and assigns, as well as myself.


This form is valid for one academic year beginning August 1st and ending July 31st.



Catawba ID:If you are not a student or employee, put the ID of your affiliated family member here.
First Name:As it appears on your Catawba ONE Card.
Last Name:
Birth Date:Month/Day/Year
Phone Number:format: 7046374111
College Affiliation: Student
Employee
Trustee
Employee's Family Member
Other




By selecting the 'Agree' option, I am acknowledging that I have read this entire Assumption of Risk and Release; fully understand it and I agree to be legally bound by it. No oral representation, statements or inducements have been made with regard to this Assumption of Risk and Release or the activities. By accepting below, I hereby certify that I am at least seventeen years of age, that I have read this entire document, that I understand its terms, that I am giving up legal rights that I might otherwise have, including the right to sue Catawba College, its governing board, officers, employees and agents, and that I have signed it knowingly and voluntarily.


THIS IS A RELEASE OF YOUR RIGHTS. READ CAREFULLY BEFORE AGREEING TO THE TERMS ABOVE.



Agree      Disagree