Acknowledgement and Assumption of Risk
Re: Participation in Athletics/Sports
(STUDENTS UNDER 18 YEARS)
During the course of the 2012-13 school year, your child will be participating in various sporting programs as selected below. Sporting activities such as those listed below involve certain elements of risk. Injuries may occur while participating in these activities.
In consideration of St. Andrew’s College permitting:
Name of Participant: Alireza Aboodzadeh (the “Child”) Grade: 11
To participate in the following: Alpine Skiing, Archery, Badminton, Baseball, Basketball, Cross Country Running, Cricket, Fencing, Flag Football, Football, Golf, Ice Hockey, Lacrosse, Nordic Skiing, Rock Climbing, Rugby, Snow Boarding, Soccer, Softball, Squash, Swimming, Table Tennis, Tennis, Track & Field, Triathlon, Ultimate, Volleyball, Water Polo, and Weight Training (Hereinafter called the “Sport(s)”).
I understand that during my son’s participation in sports, he may be exposed to situations where the stresses and hazards are greater or different, and potentially more dangerous than those he normally encounters.
Inherent risks related to participating in these sports include but are not limited to: • General athletic injuries
• Concussion and/or Head injuries
• Spinal injuries
• Sunstroke, sunburn, dehydration
• Broken bones
• Physical trauma
• Dental injuries
• Joint and soft tissue injuries
• Eye injuries
• Repetitive Strain injuries
The risk of sustaining these types of injuries result from the nature of the activity and can occur without any fault of the student, St. Andrew’s College, its employees/agents or the facility where the activity is taking place. By choosing to take part in any activity above, you are accepting that you/your child may be injured.
1) I certify that my son is fully capable of participating in such sports. He is in good health and physically fit and has not been advised by a physician against participation in activities of this nature. I know of no physical, emotional, or psychological reason why he is not capable of participating.
2) I acknowledge that the staff of St. Andrew’s College has been available to answer any questions I have had and to more fully explain the nature and demands of the sport(s) as well as the inherent risks, hazards, and dangers associated with it.
3) I understand that while participation in sport at St. Andrew’s College is considered mandatory, my son is free to choose which sports he will try-out for or participate in, and may opt out of elements with which he does not feel comfortable or safe.
4) I understand that although St. Andrew’s College has taken precautions to provide proper organization, supervision, instruction, and equipment for the sports programs in order to either eliminate or reduce the potential for loss, circumstances may arise which are not foreseeable or which are beyond the control of St. Andrew’s College or the coaching staff. 5) I acknowledge that St. Andrew’s College cannot guarantee absolute safety. I also understand that my son is, in part, responsible for his own safety. I recognize that, while participating, he must comply with instructions and directions offered by coaches, officials, athletic therapists, and medical staff from St. Andrew’s College as well as from third party service providers hired by the school. I acknowledge that it is my son’s responsibility to act prudently and carefully at all times.
I understand, acknowledge and assume the potential risks and responsibilities involved in my son’s participation in sport(s) as outlined above.
I HAVE READ THE ABOVE and fully consent to the participation of my son in ALL sports as listed below and their associated activities.
□ No (if no, please specify below)
I HAVE READ THE ABOVE and fully consent to the participation of my son in the following...
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