Structured Sports

Online Waiver Form

Waiver and Assumption of Risk

In consideration of my involvement and participation in the University of Pennsylvania sport club program, I hereby voluntarily assume any and all risks of personal injury or personal property damage which might be associated with my participation and involvement in sport club facilities/programs. I further voluntarily remise, release and forever discharge the Trustees of the University of Pennsylvania, itís successors, assigns, trustees, officers, students, employees and agents from any and all injuries, losses or damages of any kind whatsoever suffered by me as a result of my voluntary use and participation in these facilities/programs. Unless such injury or losses are caused by the sole negligence of the university, itís employees or agents while acting within the scope of their duties. I hereby certify that I am in good physical condition and that a licensed physician has verified that my physical condition is at a sufficient level to enable me to use the facilities/programs safely. I agree to follow all instructions, rules and regulations of the University regarding use of the facilities/programs while engaged in sport club activities.

Further, in consideration of my participation in the program, I agree on behalf of myself and my heirs and anyone else acting on my behalf to release, indemnify, and hold harmless, and covenant not to sue, the University and all of its employees and/or agents, including but not limited to its Division of Recreation and Intercollegiate Athletics; the program coaches and student managers and administrators; and my fellow club members from all liability for any personal injury or personal property damage I might sustain during practice, other workouts, or contests, whether supervised or on my own, and whether attributable to negligence, gross negligence, or recklessness on the part of such persons or entities.

NOTE: All fields marked with a * are required
Name *:
Date of Birth *:
Club Name *:
Email Address *:
Phone Number *:
By checking this box I certify that I have read, understand and agree to the above waiver and that the contact information that I submit is correct to the extent of my knowledge.