WE #MAKEHEALTH FEST Participation Form, Waiver and Release of Liability
I hereby acknowledge that I have been informed of the nature of the Activity and that I am aware of the hazards and risks which may be associated with participation in the Activity, including the risks of bodily injury, death or damage to property which may occur from known or unknown causes. I, on behalf of myself (if Participant is over 18) or the above-named Participant (if Participant is under 18), am exercising my own free choice to participate voluntarily in the above-named activities, and promise to take due care during such participation, including by complying with all applicable rules and instructions from the Activity Sponsor. While participating in the Activity, Participant is subject to the policies, rules and regulations of the Regents of the University of Michigan (“University”) and Activity Sponsor. Possession of fireworks, explosives, any weapon, illegal drugs or alcohol is prohibited and cause for immediate expulsion from the Activity. Further, any Participant repeatedly disobeying University or Activity Sponsor policies, rules or regulations may be expelled from the Activity. I hereby authorize Activity Sponsor, its employees, clinicians, trainers, nurses and agents the authority to seek, obtain, and approve any medical care and treatment including, but not limited to x-ray examination, anesthetic, medical, dental or surgical diagnosis, or treatment and medical care which may be recommended and provided under the general supervision of any physician or surgeon, for Participant which, in their judgment, is necessary for the health and well-being of Participant during his/her participation in the Activity. I further represent that I have health insurance covering myself (if over 18) or the Participant (if under 18) and agree and that I am solely responsible for any costs incurred and agree to hold the Activity Sponsor and University, their employees and agents harmless for any liability arising out of any good faith action taken in obtaining medical treatment for Participant. For Participants over 18 years old: I hereby release and discharge and hold harmless the Activity Sponsor and University, and its members, officers, agents, employees, and any other persons or entities acting on their behalf, against any and all damages, claims, demands, and causes of action whatsoever relating to injury, disability, death or other harm, to person or property arising from my participation in and/or presence at the above listed Activities, except for damages caused by the sole gross negligence or intentional misconduct of Activity Sponsor or University. I understand, accept, and assume all such hazards and risks, and waive all claims against the University, and other persons as set forth above. For Parent/Guardian if Participants are under 18 years old: In consideration for allowing Participant to participate in Activity, I, as parent and/or guardian of Participant, authorize Participant to participate in the Activity for the stated above and release and discharge and hold harmless the Activity Sponsor and University, and its members, officers, agents, employees, and any other persons or entities acting on their behalf, against any and all damages, claims, demands, and causes of action whatsoever relating to injury, disability, death or other harm, to person or property, except for damages caused by the sole gross negligence or intentional misconduct of Activity Sponsor or University, arising out of the participation of Participant in the Activity.