Youth Waiver Form

YOUTH WAIVER FORM
AS/SDSU AZTEC RECREATION
ASSUMPTION OF RISK, WAIVER, AND RELEASE FROM LIABILITY
In consideration of the use of the property, facilities, services, programs, activities and events provided by THE ASSOCIATED STUDENTS, including
any travel related thereto, the undersigned agrees as follows:
1. RISK FACTORS. The undersigned understands and acknowledges that the use of equipment and facilities provided by Associated Students and
participation in the AS/SDSU Recreation Programs (Intramurals, Sport Clubs (extramurals), Physical Sports, Weight and Cardiovascular training, Aztec
Adventures, Dance, Swimming, and any other programs and services sponsored by A.S. Campus Recreation Department) and related travel involves risk
such as, but not limited to, the following which might result from the use of the equipment or facilities, from the activity itself, from the acts of others, or
from the unavailability of emergency medical care: RISK OF PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLY DEATH.
2. ASSUMPTION OF THE RISK. The undersigned ASSUMES ALL RISKS WHICH ARE FORESEEABLE AND INVOLVED WITH OR ARISE
OUT OF THE USE OF THE EQUIPMENT OR FACILITIES, THE ACTIVITY ITSELF, THE ACTS OF OTHERS, OR THE UNAVAILABILITY OF
EMERGENCY CARE, including but not limited to, those RISK FACTORS described in Section 1 above.
3. ACKNOWLEDGEMENT OF POLICIES AND PROCEDURES. The undersigned acknowledges reading and knowing all of the policies and
procedures relating to the activities, facilities and/or equipment and understands that the safe and proper use of the facilities, equipment or participation in
the activity is dependent upon carefully following such policies and procedures. (See http://arc.sdsu.edu/membership for more information.)
4. PREREQUISITE SKILLS AND TRAINING. The undersigned acknowledges that he or she has the requisite skills, qualifications, physical ability
and training necessary to properly and safely use the equipment and facilities and to participate in the activity itself. The undersigned agrees that if he or
she has any questions as to what skills, qualifications or training is necessary to properly use the equipment, facility, or participate in the activity itself, then
they shall direct such questions to the appropriate Staff Member on site.
ITEMS 1–4: Initials _______
5. RELEASE. The undersigned RELEASES the State of California, the trustees of the California State Universities, San Diego State University, the
Associated Students of San Diego State University and all of their officers, employees and agents and agrees NOT TO SUE them on account of or in
conjunction with any claims, causes of action, injuries, damage, or cost of expenses arising out of the activity, including those based on death, bodily injury
or property damage whether or not caused by the negligence or other fault of the parties being released.
6. PROMOTIONAL PERMISSION. The undersigned gives permission to the Associated Students to use my name, family member’s name, written
testimonial, written evaluation and/or photographs and video in brochures, newspapers, broadcasts, telecasts, and any other form of communication.
7. WAIVER. The undersigned waives the protection afforded by any statute or law in any jurisdiction including California Code 1542 whose purpose,
substance and/or effect is to provide that a general release shall not extend to claims, material or otherwise which the person giving the release does not
know of suspect to exist at the time of executing the release. This means, in part, that the undersigned is releasing unknown future claims.
ITEMS 5–7: Initials
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8. INDEMNIFY AND DEFEND. The undersigned agrees to INDEMNIFY AND DEFEND the State of California, the trustees of the California State
Universities, San Diego State University, the Associated Students of San Diego State University and all of their officers, employees and agents (hereinafter
jointly referred to as "indemnitee") against, and hold them harmless from any and all claims, causes of action, damages, judgments, cost or expenses,
including attorney fees which in any way arise from the activity or this agreement and which include but are not limited to damages to or destruction of any
property of the indemnitee of any others, injury or death to the undersigned or anyone else or any liability arising from the act or negligent act of the
indemnitee, the undersigned or anyone else.
9. PAY. The undersigned agrees to pay for any and all damages to any property or indemnitee caused by the undersigned either negligently, willfully or
otherwise.
10. LEGAL FEES. In the event of any controversy, claim or dispute between the parties arising out of or relating to this agreement or the breach hereof
or the activity, the prevailing party shall be entitled to recover from the losing party reasonable expenses, attorney fees and costs.
11. REPRESENTATIVES. The undersigned enters into this agreement for him/herself, his/her heirs, assigns and legal representatives.
12. EMERGENCY TREATMENT CONSENT. The undersigned, as a participant (parent or guardian of minor) in the subject activity, hereby consents
to medical treatment in a medical emergency where the undersigned (minor) is unable to consent to such treatment.
ITEMS 8–12: Initials
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13. INSURANCE. The undersigned understands the Aztec Recreation Program does not carry participant insurance. The undersigned is encouraged to
have a physical examination and purchase health insurance prior to any and all participation.
14. ACKNOWLEDGMENT. The undersigned has read and understands this agreement and realizes it relates to surrendering and releasing valuable
legal rights and does so freely and voluntarily.
Signature __________________________________________________________________ Date __________________________________________________
(Parent or Guardian)
Revi ed 07/12
ITEMS 13 -14: Initials
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STAFF Initials __________