Elon University

Club Sports

Release and Indemnity Agreement

 

As part of the consideration for participating in the Elon Club Sports Program and for using the associated practice and playing facilities and equipment, and in consideration of the voluntary nature of such participation and use, I hereby release, hold harmless, and forever discharge Elon University, its employees and agents, from any and all liability, claims, demands, actions, and causes including death, that may be sustained by more or to any property belonging to me, whether caused by the negligence of the University, its employees and agents, or otherwise while participating in such activity. Such participation includes practice, club functions, competition, and travel to and from all Club Sports activities.

 

I am fully aware of the risks and hazards associated with participation and use of the facilities and equipment. I hereby elect voluntarily to participate in said activities and fully acknowledge that the full responsibility for any risk or loss, property damage, or any personal injury including death, that may be sustained by me or loss or damage to property owned by me as a result of engaged activities, whether caused by negligence of the University, its employees or agents, or otherwise. I further acknowledge that I have procured on my own adequate insurance for such loss, damage, and injury. I further agree to indemnify and hold harmless the University, its employees and agents, from any loss, damage or cost, including court costs and attorneyís fees that they may incur due to my participation in said activities, whether caused by the negligence of the University, its employees or agents, or otherwise.

 

This release and hold harmless agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or more.

 

This is the _____ day of __________________, 20____.

 

Participantís Name: _______________________________________________________

 

Club: _____________                        Participantís Signature: ____________________________

 

Participantís Phoenix ID#: __________________________________________________

 

Participantís Health Insurance Company: ______________________________________

 

Policy #: ________________________________________________________________

 

Witnessed by: ____________________________________________________________

 

Name of Emergency Contact Person: ________________________________

 

Emergency Contact Phone Number: _________________________________

 

 

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