University Center Rec Sports

Online Registration Form - Recreational Sports


First Name:   Last Name:  
Gender:  Male   Female Email:  
Home Phone:  

Cell Phone:

 

Team Name:

 

Are you the team captain?  Yes   No
Sport or Activity:

 

League:  
    Status:  
Comments:

 

LSUS Informed Consent, Waiver and Release of Liability

In consideration of my involvement under the auspices of this sponsoring organization, I acknowledge and agree that:

1. I have been directed to consult my physician prior to starting any weight loss, physical activity or exercise program.

2. I risk bodily injury, including paralysis, dismemberment, and death, as well as loss of property;

3. I knowingly and freely assume such risk;

4. I, for myself, and on behalf of my heirs, assigns and next of kin, hereby release, holds harmless, and promise not to sue Louisiana State University in Shreveport, their officers, official agents, and/or employees, with respect to any and all such injury, paralysis, dismemberment, death, and/or loss of damage to property except that which is the result of gross negligence and/or willful or wanton conduct; and

5. I wish to voluntarily participate in LSUS Recreational Sports.

Please check here if you accept these terms and conditions.

By submitting this form I agree to the conditions outlined in the above Waiver and Release of Liability.

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Louisiana State University in Shreveport
University Center
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Phone: (318) 797-5393 / Fax: (318) 798-4103
Created and Maintained by: The University Center Office (uc@lsus.edu)

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