Women’s Basketball
Incomplete waivers will not be accepted. All approved waivers will be kept on file in the Athletic Department.

Personal Information

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University Status

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Emergency Contact Information

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Health Insurance

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Release and Assumption of Risk and Cost

In consideration of the opportunity to be a participant in Athletics and /or participate in sport club activities, I, on behalf of myself, my agents, heirs and next of kin, hereby agree to release, indemnify, and hold harmless the Lourdes University, Department of Athletics and their respective employees, agents, members and representatives (herein referred to as “University”) from any responsibility or liability for personal injury, including death, and damage to or loss of property, whether or not arising from the negligence of the University, that I may incur while I am traveling to or from, engaged in practice or competition, being coached, triaged by trainers, using or operating equipment or otherwise participating in a sport club activity. In addition, I understand that the University does not provide medical insurance coverage and that I, as a member and participant in any Athletics or sports club, am encouraged to purchase personal medical insurance. In the case of injury or medical emergency and in the event participant, or their parent or guardian, cannot respond at the time of the emergency, University has permission to seek, administer, or have administered whatever first aid or emergency medical care deemed necessary for participant’s welfare, and it is understood that participant, and not University, shall be responsible for any and all charges for such health care services regardless of whether participant’s medical insurance would cover such charges. Furthermore, I recognize that every athletic team activity has a certain degree of risk, and I knowingly and voluntarily assume the risk of any injuries, regardless of severity, including death, and all risk of damage to or loss of property which I may incur, even if arising from the negligence of the University, while I am participating in an athletic team practice or tryout. I certify that to my knowledge there is no medical reason why I cannot safely participate in an athletic team practice or tryout and I agree to abide by all University policies and applicable University regulations regarding my participation in an athletic team practice or tryout.I, the undersigned, am competent to sign this release, and have read carefully, understand, and agree to all its terms.
(If participant is under age 18, parent/legal guardian signature)
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Name