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Winter Carnival Activities
Blue Key Honor Society at Michigan Technological University

Email address *
Participation Assumption of Risks and Liability Waiver
I understand and agree that Blue Key Honor Society, an organization of Michigan

Technological University students, conducts activities which involve certain risks or potential

for injury and that regardless of the precautions taken by Blue Key Honor Society or others,

some bodily injuries may occur. As a participant, I agree to conduct myself in a

responsible manner and to act safely at all times.

I certify that I have adequate insurance to cover any injury or damage I may cause or

suffer while participating, or else I agree to bear the costs of such injury or damage

myself. I further certify that I am willing to assume the risk of any medical or physical

condition I may have or may suffer while participating.

I affirm that I am in good health, have the physical ability and capacity to participate in,

and have the skills and the knowledge to safely use all equipment for activities. I also

understand that protective gear must be worn to participate in activities to help limit the

possibility of injury but acknowledge that even with such equipment injury is still possible.

I understand and assume all risk. I understand there are inherent risks that cannot be

eliminated in the activities of Winter Carnival. I affirm that I have sufficient knowledge

of the risks involved in activities and understand that there are risks not specifically

identified which are a part of the activities. I am aware of these risks and I agree to

follow all safety instructions and to ask questions if I do not understand.   I also

acknowledge that, despite careful precautions, there are certain inherent risks of injury in

activities which each participant must assume if he or she desires to participate.  

Therefore, I assume and accept all risks of and full responsibility for bodily injury, death,

loss of personal property and any expenses which may be suffered by me resulting from

any identified or unidentified dangers and risks associated with my participation in


I release all claims. I do hereby fully and forever release and discharge, and agree to

indemnify and hold harmless Blue Key Honor Society at Michigan Technological

University, its representatives, and officers, and Michigan Technological University, its

Board of Control, employees and agents from any and all claims, demands, damages, or

causes of action, present or future, whether the same be known or unknown, anticipated

or unanticipated, for bodily injury, death or property damage resulting from or arising out

of or in connection with my participation in the activities of Winter Carnival.

I understand that Blue Key Honor Society or the property owner may need to respond to

accidents and potential emergency situations. Therefore, I hereby give my consent for

any emergency medical treatment that may be required during my participation in

activities of Winter Carnival with the understanding that the cost of any such treatment

will be my responsibility. I am fully aware that I am not covered under any accident

and/or health insurance plan of Michigan Technological University.

I agree that I am responsible for transportation to and from any and all Winter Carnival

events. I further agree that I am responsible for the entire party in the vehicle, and Blue

Key Honor Society and/or Michigan Tech cannot be held responsible for any injuries or

death resulting from an accident in transit.

I affirm that I have read, and fully understand the Winter Carnival Rulebook and all safety

standards. I further agree to abide by these rules at all times when participating in Winter

Carnival, whether there is a Blue Key Honor Society representative present or not.

I agree to comply with all University rules and regulations including but not limited to

those set forth in the Housing & Residential Life policies and procedures and the

University's Code of Community Conduct.

I grant full permission for Blue Key Honor Society and the University to use personal

information such as name and email/user ID in association with group registration,

roster(s), and statistics to be posted on website and to use any photographs, videotapes or

any other record of season participation for any purpose.

Full Name *
Your answer
Team/Organization Name *
Please use the full name of your team/organization and not an abbreviation (i.e. Society of Women Engineers rather than SWE)
Your answer
Gender Identity *
What is your gender identity? This will be used for the duration of the Winter Carnival Special Events.
A copy of your responses will be emailed to the address you provided.
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