You have requested that your child be allowed to participate in the Swim & Gym 2021 at Iowa State University. All recreational activities involve risks, and it is important for you and your child to have information about this program and to provide program leaders with information about your child. This Parental Permission Agreement must be read carefully and signed by the parent/guardian of each student participant who takes part in the program. THIS IS A LEGAL CONTRACT AND AFFECTS ANY RIGHTS YOU MAY HAVE IF YOU OR YOUR CHILD ARE INJURED OR OTHERWISE SUFFER DAMAGES WHILE PARTICIPATING IN THE SWIM & GYM 2021.
Inherent Risks and Dangers of Recreational Activities
I understand and appreciate that risk is inherent when participating in recreational activities. The Swim & Gym Program involves active physical participation in team sports, gymnastics, dance, swimming, and other fitness activities. While participating in these activities, the body is subject to a variety of influences that may become potentially hazardous. Some of these hazards include, but are not limited to: cuts, abrasions, contusions, outdoor allergens, sunburn, dizziness, muscle cramps, heart attack, stroke, drowning, and a variety of other injuries, up to and including death. I affirm to the best of my knowledge, that my child is in good physical and mental health and free from cardiovascular, respiratory or other diseases or ailments, which could endanger him/her while participating in this program.
Behavior Expectations of the Participant
- Successful participation in recreational activities requires participants to abide by general rules and regulations as well as rules specific to the particular activity (swimming, volleyball, gymnastics, etc.). It is important to follow the directions of the activity leader(s) at all times.
- Participants are expected to exhibit appropriate behavior at all times. Inappropriate behavior will be discussed with the child when it occurs. Negative behavior affects more than just the participant involved in the misconduct; it can affect all those around them. If a participant is destructive to University property, the parent will be contacted for appropriate payment and/or dismissal from the program.
- The Swim & Gym Program may dismiss any participant due to violence, bullying, or other destructive behavior. Registration fees may or may not be returned at the discretion of the Program Director.
For Student Participant:
I agree to follow the ISU Swim & Gym behavior policies and participate to the best of my abilities.
I will treat other students, staff, and volunteers with respect and help to make this program safe and enjoyable for all.
Date Format: MM slash DD slash YYYY
Photographs or video/audio recordings may be taken of you/your child during ISU Swim & Gym activities. Unless you request otherwise, this Agreement will be considered permission for Iowa State University and the Swim & Gym Program to photograph, film, audio/video tape, record and/or televise your image and/or voice and/or your child’s image and/or voice for use in any publications or promotional materials, in any medium now known or developed in the future without any restrictions. If you object to ISU using your image or voice and/or your child’s image or voice in this manner, please notify the Program Director, in writing, upon submission of this Agreement.
Release and Waiver of Liability
I hereby release from liability, waive, discharge and covenant not to sue Iowa State University; Board of Regents, State of Iowa; and the State of Iowa, and any of the officers, servants, agents and employees of the above-mentioned entities (hereinafter referred to as RELEASEES) for any liability, claim and/or cause of action arising out of or related to any loss, damage or injury, including death, that occurs as a result of my child’s participation in the Swim & Gym Program 2021.
I understand all of the dangers and risks involved in the physical and recreational activities included in this Program.
I agree to indemnify and hold harmless the RELEASEES when loss, damage or injury is caused by my/my child’s negligence, gross negligence or intentional acts. I further agree that this Release and Waiver of Liability shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Release and Waiver of Liability shall be construed in accordance with the laws of the State of Iowa.
By signing this Release and Waiver of Liability, I state that I have read and understand the conditions set forth in this Parental Permission Agreement, my child and I agree to all conditions set forth herein, and I sign this voluntarily.
This Parental Permission Agreement and Release and Waiver of Liability shall be governed by and construed under the laws of the State of Iowa, which shall be the forum for any lawsuits arising from or incident to this Agreement.
- Press "Submit" to continue to the participant medical health information form.