Assumptions of Risk and Release of Liability
Free Agent Contract
S
port or Activity: ______________________________
Print Name: ________________________________
1.
I
voluntarily desire to participate in Intramural sports and Intramural Open Rec. I understand that I
am responsible for the following occurrences.
2.
I
have been encouraged to procure insurance, which provide for general medical benefits and
h
ealth and accident coverage for injury or loss I may occur.
3.
P
rior to physical activity, I should check with my doctor(s) to ensure that participation will not be a
risk to others and myself.
4. I have read and fully understand the written safety and other rules and precautions that are a part
of the requirement for my participation in the above referenced sport/activity, as well as those
explained to me by the University of Hawaii‐Hilo, its officers, agents, and employees from any and
a
ll claims of actions for property damage, and/ or personal injury which may result from my failure
to abide by these safety rules and precautions of from any inherent risk inside sport/activity.
5. I have reviewed the Intramural eligibility rules and I am currently affiliated with University of
H
awaii‐Hilo and have signed to this official team entry/roster or open recreation check‐in form
prior to participation in the program.
6. I am aware that the activity is a dangerous activity and that I may suffer bodily or other damage
arising out of participation in the activity, including travel to and from it.
T
he undersigning that I have read this assumption of risk and release of liability and consent knowingly
and voluntarily.
P
lease c
ircle you le
vel of experience below:
First Time
For Fun
High Sch
ool
College
Signature: __________________________________________
__
Student ID #: _______________________________
email: ____________________________________ Cell: ___________________________________ Shirt Size:___________