Authorization and Release – Activity Participation Form—Physical Activity
I voluntarily seek to participate in the Kids on Campus educational program offered by Carl Sandburg College. This program involves risk of harm, e.g., working with power tools; exposure to natural elements; travel to a different location; exposure to chemicals; exposure to fire; etc. I understand and acknowledge that my participation in this program may involve many risks, dangers and hazards, including risks of physical injury, disability, or death and risk of loss of use or damage to my personal property. I recognize that injuries or loss may result from unknown or unexpected risks, but may also result from equipment, materials, or facilities recommended by Carl Sandburg College, or from the acts or omissions of others or from the unavailability of immediate emergency medical care. I have made a voluntary choice to participate in these activities despite the risks, dangers, and hazards. I understand Carl Sandburg College does not provide any accidental death, disability, dismemberment or medical expenses insurance on behalf of the participants in College activities.
In consideration for the educational opportunity provided to me, I agree to assume all the risks, responsibilities, and expenses associated with my participation in the learning experiences, the related transportation, and in any other related activities, and in advance, I hereby waive liability, release, hold harmless, covenant not to sue, and forever discharge the Board of Trustees of Carl Sandburg College, and its members individually, and its officers, agents, employees, representatives, volunteers and any students acting as employees, (hereafter “Releasees”) from any and all liability, claims, demands, rights, and causes of action of whatever kind, including claims for personal injury, property damage, and/or the consequences thereof and attorneys’ fees and court costs, whether caused by the negligence or carelessness of the Releasees or otherwise, resulting from or in any way connected with my participation in the program.
I acknowledge I do not have any medical or other condition that would preclude me from participating in these activities or programs. Further, I understand if I do have a condition that would impact my ability to participate, I must contact the individual in charge of the activity and/or program to discuss any questions and concerns I might have regarding my ability to participate.