ACKNOWLEDGMENT OF RISK, RELEASE, AND MEDICAL AUTHORIZATION
IN CONSIDERATION of my child being permitted to participate in IMPACT at or with Lipscomb University, I, the undersigned parent/guardian, in full recognition and appreciation of the dangers and hazards inherent in participating in such activity, the hazards inherent in transportation to and from any destination, the hazards inherent with this activity and in the circumstances to which my child may be exposed during his/her participation in the activity, do hereby agree to assume full responsibility for any risk of loss, damage or injury, including death, which may result from my child’s participation in the activity or any independent activities undertaken as a part thereof; and
FURTHER, I do for myself and my child’s personal representative(s), heirs and assigns, hereby agree to defend, hold harmless, indemnify, release, forever discharge and covenant not to sue the activity sponsor(s), Lipscomb University and all its trustees, officers, agents and employees from and against any and all losses, damages, claims, demands and actions, including reasonable attorneys’ fees, arising out of or related to any loss, damage or injury, including death, which may result from my child’s participation in such activity, and while traveling to or from the destination of the activity, whether caused by the negligence of Lipscomb University or any of its trustees, officers, agents or employees or otherwise; and
FURTHER, in order that my child may receive necessary medical treatment in the event of injury or illness during participation in such activity, I hereby authorize the activity sponsor(s), school officials and their designee(s) to administer and/or obtain appropriate treatment in the event of such illness or injury and I hereby agree to defend, hold harmless, indemnify, release, forever discharge and covenant not to sue the activity sponsor(s), Lipscomb University and all its trustees, officers, agents and employees from and against any and all losses, damages, claims, demands and actions, including reasonable attorneys’ fees, as a result of the exercise of the authority granted herein; and
FURTHER, I understand and acknowledge that Lipscomb University has established rules and regulations pertaining to conduct, behavior and activities of students by which I must abide during participation in such activity, and I agree to abide by all such applicable rules and regulations at all times during my participation in the activity.
I have read and understood this Acknowledgement of Risk, Release and Medical Authorization, am at least eighteen (18) years of age and fully competent and execute the same as my own free will.