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The
University of Akron High School Indoor Meet Waiver
Form
Emergency
Medical Authorization
I am aware of the risks, hazards and inherent dangers that may arise due
to my child's participation in the University of Akron Indoor Track &
Field Meet being held at The University of Akron. (collecively referred
to as the "UNIVERSITY").
In consideration for being allowed to participate in said activity, I
herby release, waive and discharge UNIVERSITY, its instructors, agents,
and employees from every claim, liability or demand of any kind sustained,
whether caused by negligence of the UNIVERSITY or otherwise. This release
shall be binding upon any heirs, administrators, executors and assigns
of mine.
I further agree to indemnify the UNIVERSITY from any loss, liability,
damage, or cost they may incur during participation in said activity in
any way whether caused by the UNIVERSITY or otherwise.
In the event of illness or injury resulting or arising directly or indirectly
out of said activity, I hereby give my my consent and authorization for
(1) the administration of emergency first aid care and treatment at the
scene of the emergency by faculty, staff memebrs or volunteers of the
UNIVERSITY or (2) the adminstration of any treatment deemed necessary
by a licensed physician or dentist and (3) the transfer to any hospital
reasonably accessible. The authorization is not intended to cover major
surgery unless the medical opinions of two (2) licensed physicians or
dentists, concurring in the necessity for such surgery, are obtained prior
to the performance of such surgery.
I further declare and warrant that I am covered by sufficient medical
and dental insurance and that such insurance will remain in effect during
my child's participation in said activity.
____________________________________________ _________________
Signature
of Parent or Guardian
Date
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