Rutgers Dance Team Activity Waiver — College-18-Under
2019 Dance Team Fall College Clinic
PARENTAL INFORMED CONSENT/WAIVER/RELEASE IF UNDER 18
I am the parent of a minor desirous of participating in a program administered by the Rutgers University Spirit Program and utilizing the Rutgers Athletic Center in Piscataway, NJ on Sunday, October 6, 2019. I recognize and acknowledge the following:
Child's Name (please print):
Parent's Name (please print):
Parent's Signature:
Date:
I am the parent of a minor desirous of participating in a program administered by the Rutgers University Spirit Program and utilizing the Rutgers Athletic Center in Piscataway, NJ on Sunday, October 6, 2019. I recognize and acknowledge the following:
- That I am aware that when my son/daughter is working out, exercising or playing sports at the recreation/ athletic facilities, it has been known to result in serious injury such as sprained ankles, broken limbs, etc;
- Participation is voluntary;
- I further acknowledge that exercising is a strenuous activity which requires proper physical conditioning;
- That my son/daughter is physically able to participate and know of no disability or prior injuries which would prevent my participation;
- That my son/daughter will follow all rules established by the recreational/athletic facilities;
- In the event that a need for emergency medical services arises, I authorize and consent to such service being provided to my son/daughter and assume the cost thereof;
- I understand that my son/daughter is not covered by any insurance plan of Rutgers, The State University of New Jersey.
Child's Name (please print):
Parent's Name (please print):
Parent's Signature:
Date:
