UREC Sports Clubs Participation Statement

Informed Consent/Travel Agreement

Each participant of all respective Sport Clubs must read, complete, and sign the following form before any and all involvement in activities related to their sport club, this includes tryouts. Form must be updated yearly and kept on file in the Student Leadership Office, 3rd floor, UREC.

I, ______, as a current or potential member of the James Madison University ______Club, affirm that I have no medical, physical or mental health conditions which would hinder or prevent my active participation in the referenced activity, and that I am voluntarily participating as a member of the aforementioned club. I am aware that such participation involves a risk of injury, which may include severe injuries, potentially involving paralysis, permanent mental disability, or death, and that I am assuming any risk that may be involved with participation in this sport.

I hereby release and promise not to sue the Commonwealth of Virginia, James Madison University, its agents or employees, from and for any injury (including sickness or death) to me, or damage or loss to my property, arising out of my participation in this program, no matter the cause. I understand that the only exception to the preceding term would be if injury, loss or damage is due to intentional misconduct on the part of an employee or agent of the Commonwealth of Virginia.

I also understand that I am financially accountable for all Sport Club equipment that I utilize or that which is placed in my care. I understand and agree to adhere to UREC Sport Club policies and procedures, and will represent that Club and University Recreation (UREC) accordingly.

I understand that coaching is not provided by James Madison University, but by the club – this individual may be an undergraduate student. I waive the right to recover damages for injury from the university as a result of actions, inaction, omission and/or negligence of a coach.

SPORT CLUBS PARTICIPANT TRAVEL AGREEMENT

I, a member of the James Madison University ______Club in order to fully participate in all activities associated with the club agree to abide by the following statements. These guidelines were established to ensure that I behave in an appropriate and respectful manner as a student as well as a member of an organization sponsored by James Madison University, University Recreation Department and the Sports Club Council.

  1. I will uphold the JMU Honor Code.
  1. I will abide by all local and state laws.
  1. I will follow the policies and procedures set forth by UREC, James Madison University, the National Intramural-Recreational Sports Association and the national governing bodies of my club.
  1. I will abide by the rules and guidelines set forth by the University with whom we are competing or by the tournament in which we are participating.
  1. I will behave in a sportsman-like manner in all competitive or non-competitive events.
  1. I will abide by the rules, regulations and requests of the hotel in which we are staying.
  1. I will not participate in any activity that would deem harmful or destructive to any persons or private property. I understand that I am responsible for any damage to property. This includes, but is not limited to, all modes of transportation, hotels, tournament sites, recreation centers and club or university sports equipment.

I have read and understand all of the above statements; policies set forth and agree to follow each. I also understand that if I fail to follow these guidelines I will accept full responsibility for myself and the consequences that will be imposed on me and my club members.

PRINTED NAME: ______

JAC CARD NUMBER: ______

BIRTH DATE: ______

SIGNATURE: ______DATE: ______

EMERGENCY CONTACT NAME & PHONE #: ______

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If a sports club member is under the age of 18, his/her parent of guardian must sign below consenting participation based on the aforementioned statements of responsibility.

PARENT/GUARDIAN PRINTED NAME: ______

PARENT/GUARDIAN SIGNATURE: ______

PARENT/GUARDIAN PHONE NUMBER: ______DATE ______

SPORT CLUB COORDINATOR APPROVAL SIGNATURE: ______