TAMU ChallengeWorks Waiver (Minors)
This waiver is required to be completed by all participants and observers. If you are a minor, please have your parent/legal guardian read, fill out, and sign the waiver for minors. 
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Email *
ChallengeWorks is program in the Department of Kinesiology and Sport Management at Texas A&M University.

Section 1

I, ____________________________________, understand the ChallengeWorks program (“Activity”) in which I plan to be a participant involves certain inherent risks and that regardless of the precautions taken by ChallengeWorks, some bodily injuries may occur. I understand the types of risks associated with this activity include, but not limited to: slipping, tripping, falling, hypothermia (reduced core body temperature), hyperthermia (elevated core body temperature), dehydration, insect bites and stings, snake bites, cuts, scrapes, broken bones, sunburn, blisters, exposure to weather conditions and environmental conditions (dead fall, swift water, and uneven or slippery terrain.) I understand that certain activity may cause suddenly elevated heart rates, which could lead to serious consequences including death if I have heart disease, hypertension, or other conditions affected by surges in heart rate. I understand program leaders are not the guarantors of my safety. My participation in this activity is voluntary.

Sign Name for Section 1 *
Section 2

I agree to follow all instructions and guidelines given by the program leader(s), and to act in a safe and responsible manner toward all participants.  I understand program leaders have the discretion to limit or prevent my participation; otherwise, I will choose my own level of participation.

Initial for Section 2 *
Section 3

I understand that participation in this activity includes the use of ropes and other climbing equipment.  I understand that the use of this equipment carries with it the risk of equipment failure and, of necessity, requires a participant to rely on the cooperation, skill, and ability of other participants which can result in unexpected and unintended consequences.  I understand I may choose whether or not to participate in any activity based upon my own personal assessment of my abilities and the risks associated with that activity.

Initial for Section 3 *
Section 4

I understand Texas A&M University does not carry medical insurance to cover claims associated with injuries sustained while participating in this activity.  I understand any medical insurance covering my injuries must be provided by me.  This paragraph does not apply to participants who are employees of Texas A&M University participating in the program within the course and scope of their employment.

Initial for Section 4 *
Section 5
I agree not to use illegal drugs or alcohol during any part of the program and understand that such use may lead to dismissal from the program.
Initial for Section 5 *
Section 6
In consideration for receiving permission to participate in ChallengeWorks, I hereby release, waive, discharge, and covenant not to sue, and agree to hold harmless for any and all purposes, Texas A&M University, the Outdoor Education Institute, The Texas A&M University System and its Board of Regents, and their officers, servants, agents, volunteers, or employees (herein referred to as RELEASEES) from any and all liabilities, claims, demands, or injury, including death, that may be sustained by me while participating in such activity, or while on the premises that is owned, leased, or controlled by RELEASEES, including travel to and from ChallengeWorks activities, including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of RELEASEES.  I understand this waiver does not apply to injuries caused by intentional or grossly negligent conduct.  I further agree to indemnify and hold harmless RELEASEES for any loss, liability, damage or costs, including court costs and attorney’s fees that may occur as a result of my participation in said activity , including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of RELEASEES.I understand this agreement to indemnify and hold harmless does not apply to injuries caused by intentional or grossly negligent conduct by RELEASEES.  This paragraph does not apply to participants who are employees of Texas A&M University participating in the program within the course and scope of their employment; these participants may still be eligible for worker’s compensation benefits for injuries sustained during this activity.
Initial for Section 6 *
Section 7
I understand RELEASEES cannot be expected to control all of the risks articulated in this form but RELEASEES may need to respond to accidents and potential emergency situations.  Therefore, I hereby give my consent for any medical treatment that may be required during my participation with the understanding that the cost of any such treatment will be my responsibility.  I agree to indemnify and hold harmless RELEASEES for any costs incurred to treat me, even if a RELEASEE has signed hospital documentation promising to pay for the treatment due to my inability to sign the documentation.
Initial for Section 7 *
Section 8
I permit Texas A&M University to record, own, and publish reproductions of my likeness taken during the activity for educational, marketing, and publicity purposes. I acknowledge that the pictures become the sole and exclusive property of Texas A&M University.
Initial for Section 8 *
Section 9
I expressly acknowledge the health risks and dangers associated with the transmission of the COVID-19 virus, and other communicable diseases, and recognize that exposure to the COVID-19 virus, or other communicable diseases, could occur while myself or my child is in the care of sponsor.  As such, and as additional consideration for participation in the activity, I understand the waiver and indemnity provisions in paragraphs above apply to the possibility of COVID-19 community spread.  I certify that prior to leaving my child in the care of the sponsor that my child: (a) has not been diagnosed or is suspected to have COVID 19, (b) does not have any of the coronavirus symptoms listed on the CDC’s Symptoms of Coronavirus page, (c) has not in the past 14 days had close contact (less than six feet) with a person who has a lab-confirmed case of COVID-19, (d) has not in the past 14 days had close (less than six feet) contact with a person who is awaiting results of a COVID-19 test because of COVID-19 symptoms or exposure, or (e) in the past 14 days has not returned from international travel or traveled through an area with state or local restrictions that mandate quarantine upon arrival home. I also certify that each time I leave my child in the care of the sponsor, I have conducted a daily assessment on my child and that he/she is not exhibiting any of the above signs or symptoms of, or exposure to, COVID-19.
Initial for Section 9 *
Section 10
This agreement shall be legally binding upon heirs, assigns, legal guardians, personal representatives, and me.  I have carefully read this agreement and understand its contents.  I am aware that I am releasing certain legal rights that I otherwise may have, and I enter this agreement, on behalf of myself, of my own free will.
Initial for Section 10 *
Section 11

I/We (parents or guardians name) _________________________ give permission to our child (Child’s name) ___________________________ to participate in the ChallengeWorks program. In the event of an emergency, I / We request that the program leader(s) secure emergency medical services to aid our child, if it is in their best judgment that such services are necessary. I / we agree to incur any expense associated with such action.

Child's Name *
Electronic Signature Consent - Parent's/Legal Guardian's Signature (First and Last Name) *
Today’s Date *
Name of Organization and/or Program Name

(please do not list TAMU, Texas A&M University or ChallengeWorks; please list the name of the organization you are in)
In case of an emergency, who do we contact and what is their number? *
If the participant has medical insurance, please indicate the following:
  • Insurance Company
  • Policy Number
  • Name of Primary Policy Holder
  • List of any special services your child may require
Insurance Company *
Policy Number *
Name of Primary Policy Holder *
Please list any special services your child may require: *
A copy of your responses will be emailed to the address you provided.
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