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STATEMENT OF PERSONAL RESPONSIBILITY & RELEASE REGARDING PARTICIPATION IN

WASHINGTON UNIVERSITY STUDENT EVENT

(For students under the age of 18)

 

1.       My child is a student at Washington University in St. Louis (the “University”).


2.       He/she wishes to participate in the Beyond Boundaries Event at Steinberg Skating Rink in St. Louis, Missouri on December 7, 2024 (collectively, the “Event”). Event activities include, but are not limited to: ice skating at Steinberg Skating Rink, off-campus dining, and outdoor activities. I understand that participants will be responsible for their own transportation to/from the destination. I acknowledge that my child has voluntarily chosen to participate in the Event despite the potential dangers and risks, and despite this release. I further understand that any time spent at Steinberg Skating Rink outside of the activities and time period designated for the Event will be considered optional activities, and that my child will participate in them at his/her own risk.

 

3.       I understand and appreciate the dangers, hazards and risks inherent to the Event, including but not limited to transportation to, from, and around the Event locations, natural disasters, inclement weather, exposure to cold or heat, dehydration, accidents, falls, lacerations, burns, broken bones, insect or other animal bites, and other injuries (including injuries that could result from ice skating, off-campus dining, and outdoor activities), illnesses (including COVID), diseases, crimes, riots, terrorist activities or attacks, and any risks associated with independent activities my child undertakes as an adjunct to the Event, all of which could include serious or even fatal injuries or property damage or loss. Such damage, injuries and/or death may result not only from my child’s own action, inaction or negligence but also the action, inaction, or negligence of others.  I further understand that the University, including the individuals acting on its behalf, cannot and does not assume responsibility for such events or personal injuries or property damage arising therefrom even if such injury or damage is a result of the negligence of the University or other parties released.  I also accept that it is my child’s sole responsibility to participate only in those activities for which he/she has the prerequisite skills, qualifications, preparation, and training, and that I have read and understand the conditions applicable to the Event. I further accept and agree that my child will follow all instructions pertaining to the Event, particularly those regarding safety and security practices.   

       

4.       With full knowledge of the dangers, hazards and risks of the Event, and in consideration of my child being permitted to participate in them, on behalf of myself, my child,  my family, heirs, and personal representative(s), I agree to assume all the risks and responsibilities surrounding my child’s participation in the Event and, in advance, release, waive, forever discharge, and covenant not to sue the University, its governing board, officers, agents, employees, students, and volunteers (collectively, the “Releasees”) from and against any and all liability for any harm, damage, claim, demand, action, cause of action, cost or expense of any nature that I or my child may have or that may hereafter accrue to me or my child, arising out of or related to any loss, damage or injury, including but not limited to physical injury, suffering or death, that may be sustained by my child or by any property belonging to my child, whether caused by the negligence or carelessness of the Releasees with regard to the Event. This waiver does not pertain to incidents involving gross negligence or willful misconduct by the University and/or its agents. It is my express intent that this Release shall be deemed a release, waiver, discharge and covenant not to sue the Releasees. I further agree to save and hold harmless, indemnify, and defend Releasees from any claim by me, my child or my family arising out of my child’s participation in the Event.

 

5.       I understand that my child is expected to behave in a manner consistent with the Washington University Student Conduct Code, the Washington University Drug and Alcohol Policy, and all other applicable University policies. I understand that the use or possession of alcohol or illegal drugs, including marijuana, by my child can have very grave consequences, including arrest and imprisonment. I know that my child is subject to local law and that my child agrees to obey all laws and ordinances of jurisdictions where he/she may be during his/her participation in the Event. I understand that if my child does not behave in accordance with policy and law, he/she may be asked to leave the Event and will be responsible for all personal expense thereafter, including return transportation.

 

6.       I am aware of my child’s personal medical needs and state that there are no health-related reasons or problems that preclude or restrict his/her ability to participate safely in the Event. I assume all risk and responsibility for my child’s medical needs, and understand and agree that if he/she must be hospitalized or otherwise receive medical care, the University cannot and does not assume legal responsibility for payment of such costs. I hereby warrant that my child has adequate health insurance coverage to meet any and all needs for payment of medical costs while undertaking the Event. I hereby grant permission to the Releasees to authorize emergency medical treatment for my child, and understand and agree that neither the University nor any of the other Releasees assume any responsibility for any injury or damage that may arise out of or in connection with such authorization.

 

7.       I warrant that I am the parent of the Washington University student participating in this event and that I am fully competent to sign this Release; that I understand the terms contained herein are contractual and not a mere recital; that I have read this Release with full knowledge of its significance; and that I have signed this Release as my own free act.

 

I agree that this Release shall be construed in accordance with the laws of the State of Missouri. If any term or provision of this Release shall be held unenforceable, illegal, or in conflict with any governing law, the validity of the remaining portions shall not otherwise be affected.


THIS IS A RELEASE OF LEGAL RIGHTS.  

READ IT AND BE CERTAIN YOU UNDERSTAND IT BEFORE SIGNING.


ACCEPTED AND AGREED: 


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First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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