Albion College: Athletic Activity Waiver

      Student Birthdate
      Student Birthdate


      USE of ATHLETIC FACILITIES, FITNESS EQUIPMENT CENTERS,
      BY NON-STUDENTS

      RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF
      RISK AND INDEMNITY AGREEMENT

      (“Participant”), hereby acknowledge that I have voluntarily elected to use Albion College’s fitness facilities and equipment (“Facilities”).  I further hereby acknowledge that I have permission to use, Albion College’s public athletic facilities (including the Dow and fitness centers and/or equipment located within various buildings on the Albion College campus (together, “Facilities”). I acknowledge that my participation and use is elective and voluntary.  In consideration for being permitted by Albion College (“INSTITUTION”) to use Albion College’s Facilities, I hereby acknowledge and agree to the following:

      RULES AND REQUIREMENTS: I agree to conduct myself in accordance with Albion College’s policies and procedures.  I further agree to abide by all the rules and requirements of the Facilities. I acknowledge that Albion College has the right to terminate my use of its Facilities if it is determined that my conduct violates any rule of the Facilities, or is detrimental to the best interests of the Facilities or others using the Facilities, or for any other reason in the College’ s discretion.

      INFORMED CONSENT:  I have been informed of and I understand the various aspects of the  use of the Facilities.  I understand that as a user of the Facilities, I will engage in physical activities, including but not limited to practicing, training, observing, and possibly competing in Facilities events, and that during my participation I could sustain serious personal injuries that protective equipment may be inadequate to prevent such serious personal injury and that participating in such activities may result in serious bodily injury to and including but not limited to virtually all bones, joints, muscles, and internal organs, cardiac problems, drowning, brain damage, illness, damage, or even death as a consequence, as a consequence of not only Releasee’s (as defined herein) actions, inactions, negligence or fault but also the actions, inactions, negligence or fault of others, conditions of equipment used, facility conditions, weather conditions, improper lifeguarding, officiating or refereeing, negligent first aid operations and procedures and I understand that there may be other risks not known to me or not reasonably foreseeable at this time.  I further understand that the risks associated with physical activities include, but are not limited to, sprains, cuts, contusions, abrasions, concussions, broken bones, bone fractures, and in some extreme cases long-term injuries, including but not limited to brain damage that may result in mental and emotional disabilities, and/or physical damage, including but not limited to the musculoskeletal, nervous, respiratory and/or urinary systems, and/or death.  I understand and agree that any injury, illness, damage, disability, or death that I may sustain by any means is my sole responsibility, except as explicitly specified in this Agreement.

      ASSUMPTION OF RISKS:  I understand and acknowledge that there are potential dangers incidental to my use of the Facilities, including risks of damage, bodily injury and possibly death as discussed throughout this Agreement.  The risks may result from the activity itself, from the acts of others, from use of the equipment or Facilities, or organization of or unavailability of emergency medical care.  Potential risks with respect to use of the Facilities are as follows:

      Athletic Facilities: Dangers incidental to my use of Albion College’s athletic facilities may include activities such as, practicing, training, observing, utilizing equipment, and competing in events within the College’s athletic facilities.  I understand that risk varies based upon the activities (including Facilities) in which I participate within the facility.  I am aware that certain activities (including Facilities) can involve vigorous activity involving severe cardiovascular stress and/or violent physical contact.  I understand that certain activities involve certain risks, including but not limited to, death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damages, and serious injury to virtually all bones, joints, muscles, and internal organs, and that protective equipment may be inadequate to prevent serious injury.  I understand that the athletic facilities may not offer protective equipment, and that I am responsible for ensuring I use protective equipment as necessary.  I further understand that Albion College personnel may not be present in the athletic facilities at all times.  I understand that I am responsible for following the rules and requirements posted in any athletic facility and I enter and use the facility at my own risk.

      Fitness Equipment Center(s): Albion College has facilities for and provides activities such as weight lifting, running, aerobic activities, classes and sporting activities.  Some of these activities involve strenuous exertions of strength using various muscle groups, some involve quick movements involving speed, change of direction, and sustained physical activity, which place stress on the cardiovascular and musculoskeletal systems. I understand that certain activities involve certain risks, including but not limited to, death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damages, and serious injury to virtually all bones, joints, muscles, and internal organs.  Various machines, apparatus, and equipment are offered in the fitness centers.  I understand that these should be used responsibly at all times.  I further understand that Albion College personnel may not be present in the fitness centers.  I understand that I am responsible for following the rules and requirements posted in any fitness facility and I enter and use the facility at my own risk.

      Swimming Pool: I further understand that the Facilities in which I am participating involves or may involve a swimming pool.  I am aware that any contact with a swimming pool involves certain risks, including but not limited to: death, drowning, or other personal injury as a result of the area’s conditions, the acts of third parties or other unknown safety hazards, diving injury, skin, eye, lung and ear irritation, injuries resulting from loss of balance and footing on aquatic surfaces, injuries resulting from lack of oxygen, injuries due to conditions of equipment, unpredictability of weather and the water conditions, first aid operations or procedures of Releasees and/or others, and that there may be other risks not known to me or not reasonably foreseeable at this time. 

      I KNOWINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE ACTS OF THE RELEASEES (AS DEFINED HEREIN), UNLESS THE RISKS ARISE FROM THE RELEASEES’ NEGLIGENCE, GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT and I assume full responsibility for my participation in the Facilities and use of the Facilities.

      RELEASE AND WAIVER OF LIABILITY:  I, on behalf of myself, my personal representatives, heirs, executors, administrators, agents, and assigns, HEREBY RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUEAlbion College including its governing board, trustees, directors, officers, employees, and any students, agents or volunteers acting at Albion College’s direction (collectively referred to as "Releasees"), for any and all liability, including any and all claims, demands, causes of action (known or unknown), suits, or judgments of any and every kind (including attorneys’ fees), arising from any injury, damage or death that I may suffer as a result of my use of the Facilities, REGARDLESS OF WHETHER THE INJURY, DAMAGE OR DEATH IS CAUSED BY THE RELEASEES, UNLESS THE INJURY DAMAGE OR DEATH IS CAUSED BY THE RELEASEES’ NEGLIGENCE OR GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT, AND REGARDLESS OF WHETHER THE INJURY DAMAGE OR DEATH OCCURS WHILE IN, ON, UPON, OR IN TRANSIT TO OR FROM THE PREMISES WHERE THE ACTIVITY, OR ANY LOCATION ADJUNCT TO THE ACTIVITY, OCCURS OR IS BEING CONDUCTED. 

      I further agree that the Releasees are not in any way responsible for any injury or damage that I sustain as a result of my own negligent or grossly negligent acts or my own intentional misconduct and I hereby release Releasees from any liability for the same.

      Albion College expressly disclaims liability for actions of third parties, which includes but is not limited to students, agents or volunteers who are not acting under the direction and control of Albion College.  I, hereby release Releasees from any and all liability, including any and all claims, demands, causes of action (known or unknown), suits, or judgments of any and every kind (including attorneys' fees), arising from any injury, damage or death that I may suffer as a result of actions of any third parties who are not Releasees. 

      INDEMNITY:  I, on behalf of myself, my personal representatives, heirs, executors, administrators, agents, and assigns, agree to hold harmless the Releasees from any and all liability, including any and all claims, demands, causes of action (known or unknown), suits, or judgments of any and every kind (including attorneys' fees), arising from any injury, damage or death that I may suffer as a result of my use of the Facilities, REGARDLESS OF WHETHER THE INJURY, DAMAGE OR DEATH IS CAUSED BY THE RELEASEES OR OTHERWISE, UNLESS THE INJURY, DAMAGE OR DEATH IS CAUSED BY THE RELEASEES’ NEGLIGENCE, GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT.

      I further agree that, in the event that I or any of my family members, personal representatives, heirs, executors, administrators, agents, assigns or any other third party attempts to assert any claims, demands, causes of action (known or unknown), suits, or judgments of any and every kind (including attorneys' fees), arising from any injury, damage or death to me, including but not limited to any injury resulting from my own negligence, gross negligence or intentional misconduct during or related to the Student Activity, I AGREE TO DEFEND AND INDEMNIFY RELEASEES AGAINST SUCH CLAIMS, DEMANDS, CAUSES OF ACTION (KNOWN OR UNKNOWN), SUITS, AND/OR JUDGMENTS OF ANY AND EVERY KIND (INCLUDING ATTORNEYS’ FEES) TO THE FULLEST EXTENT PERMITTED BY LAW.

      CERTIFICATION OF FITNESS TO PARTICIPATE:  I attest that I am physically and mentally fit to use the Facilities and utilize fitness equipment and that I do not have any medical record or history that could be aggravated by my participation in my particular activity.  I further attest that I am physically and mentally fit to participate in fitness activities in the fitness centers, and that I am responsible for consulting with my health care provider towards this end.

      RESPONSIBILITY FOR REPORTING INJURIES:  I acknowledge that I must be an active participant in my own healthcare and as such, it is my responsibility to report all injuries and illnesses, including signs and symptoms of concussions, to Albion College’s qualified health care provider.  I hereby affirm that I have fully disclosed in writing any prior medical conditions and will also disclose any future conditions to the Albion College’s health care provider.

      MEDICAL CONSENT:  I understand and agree that Releasees do not have medical personnel available at the location of the Facilities, nor at the Facilities.  In the event of any medical emergency, I (select and initial below) do/do not authorize and consent to any x-ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care that Albion College personnel deem necessary for my safety and protection.  I understand and agree that Releasees assume no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment.  I further understand that in the event that I experience any condition requiring emergency medical treatment, Albion College may direct that I be transported to the hospital for such care. (1)
      PROMOTIONAL RIGHTS: As a condition of my participation, I hereby grant ALBION COLLEGE the right to use, for promotional purposes only, any photographs of me taken by ALBION COLLEGE , its employees or agents, during my participation in the Program. I further understand and agree that ALBION COLLEGE may use (for marketing purposes) any statements or quotes attributed to me in my evaluation of the Program. 

      Footnote: (1) [In the event that person expressly declines medical treatment on the waiver, an officer at the institution should immediately have a conversation with the person to ensure that the person fully understands the risks of declining medical treatment.  The person should also be informed that if he or she reasonably appears to be experiencing an emergency medical condition, the institution will transport the person to the hospital. 
      In the event that a person who has declined medical treatment experiences an injury or medical condition that appears to require emergency treatment, the institution should transport the person to the hospital’s emergency room.  Such transportation is authorized under the federal Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates medical screening examination and treatment for all patients presenting to an emergency department with an emergency medical condition.  Neither parental nor patient consent is needed for such care.  Moreover, once the person is at the hospital, the institution should ensure that the examining health care provider (not the institution) fully explains the risks of not proceeding with treatment to the person.  The treating physician should also document the person’s refusal of medical treatment in writing.  If the person is comatose and unable to decline medical treatment but previously declined medical treatment in his or her waiver, he or she should also be transported to the emergency room.]

      NON-EMPLOYEE STATUS:  I understand and acknowledge that in participating in the Facilities and to use Albion College’s Facilities, I am doing so independently and that I am not an employee or agent of Albion College. I understand and agree that as a non-employee that I am not entitled to receive compensation or any other employee benefit from Albion College for my use of the College’s Facilities.

      CHOICE OF LAW: I hereby agree that this Agreement shall be construed in accordance with the laws of the State of Michigan. 

      SEVERABILITY: If any term or provision of this Agreement shall be held illegal, unenforceable, or in conflict with any law governing this Agreement the validity of the remaining portions shall not be affected thereby.  

      I hereby acknowledge that I have read, understand and will abide by each of the terms and conditions of this Agreement.  I understand that I may seek legal counsel of my own choosing to fully explain any terms of this Agreement to me before I sign it.

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      Signature of Parent/Guardian for Participants Who Are Minors (Under 18 Years Old):

      I certify that I have custody of Participant or am the legal guardian of Participant by court order. I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND AND AGREE TO ITS TERMS.  I AM AWARE THAT THIS AGREEMENT INCLUDES A RELEASE AND WAIVER OF LIABILITY, AN ASSUMPTION OF RISK, AND AN AGREEMENT TO INDEMNIFY RELEASEES. 

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