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UMW Recreational Sports and Club Risk and Insurance Form

Step 1 of 2

Informed Consent and Acknowledgement of Risk

-I acknowledge that sport and recreation clubs provide structured competitive opportunities for men and women with varied interests and skill levels with the intent to provide wholesome and positive experiences for all who participate. My signature below signifies my acceptance of the rules and policies of The University of Montana Western.

-I understand that every attempt is made to minimize the existing risk (that are inherent in the nature of some of the activities) through the use of proper sports equipment, safe facilities and sound safety practices. However, I also understand that these risks cannot be eliminated completely.

-I realize that as a recreation or sport club participant, I could possibly incur injuries no matter how well conditioned I may be. Due to the nature of sports, injuries may be minor to fatal in nature. Some specific injuries that are not uncommon to recreation and sports are listed below:

-A stoppage of breathing; spine and neck injuries (either of which could result in paralysis); heart failure; broken bones; heat stroke; heat cramp; heat exhaustion; stroke; bleeding; convulsion unconsciousness; abrasions; fainting; sudden illness; cramps; and loss of wind. In addition, there is a potential for accidents or illness while traveling to and from events.

-The propensity for major injuries, such as broken bones, concussions, and internal injuries to major organs, increase in relation to the force of impact upon a collision between two moving players. I understand that if I am participating in a collision sport, speed collisions will occur regularly, as an integral part of the sport.

-These lists above are not intended to be inclusive of all injuries that may occur, but rather to inform me of the type of risks inherent in my participation in UMW sport or recreation clubs, so that I can make a voluntary choice to participate or not participate.

-I also realize that the activity involved may be strenuous and that UMW has advised me to seek the advice of my physician before participating in this activity.

-I hereby affirm that in consideration of the University’s providing support for this club and allowing me to participate, I am voluntarily participating in any or all of the activities of The University of Montana Western Clubs with full knowledge of the potential danger which they present, including bodily injury, property damage, and death, and I hereby agree to accept any and all risk of such bodily injury, property damage, and death.