Rec Center Liability Waiver

All Recreation Center patrons should complete the liability waiver and Physical Activity Readiness Questionnaire.

NOTICE OF ASSUMPTION OF RISK - WAIVER AND RELEASE

The Dordt University Recreation Center provides equipment and programs for recreation and exercise. Because of the nature of the equipment and programs there are inherent risks of injury. For and in consideration for the opportunity to participate in activities within the Dordt University Recreation Center, which are not part of an academic program or required for the fulfillment of my obligations towards obtaining a degree, I voluntarily agree to the following terms and conditions:

I certify that I have read this document, understand its provisions, and agree to its terms which constitute legally binding consent, assumption of risk, waiver of claims, and indemnity for participating in activities at the Dordt University Recreation Center.

I understand and acknowledge that participating in activities at the Dordt University Recreation Center includes some inherent and dangerous risks that could result in harm, loss, damage, personal injuries, illnesses, or death. Risks include, but are not limited to, falling, slipping, muscle or skeletal injuries, collisions, respiratory issues, strains, sprains, fractures, dislocations, heart attack, stroke, heat stress, drowning, or even death. I voluntarily choose to participate in such activities with full knowledge that the activities may be hazardous. I voluntarily assume full responsibility for any risks of injury, loss, or property damage. I further assume full responsibility for all such damages caused to others by my conduct.

In consideration of Dordt University permitting me to participate in activities within the Dordt Recreation Center, I agree to indemnify, defend, hold harmless, discharge and release Dordt University, their agents, employees, and officers from all liability, claims, causes of action or demands of any kind and nature whatsoever, including attorney's fees incurred by Dordt University that may arise from or be related to my use of facilities. This release shall be binding not only for me, but upon my heirs, administrators, executors, successors, and assignees regarding the Dordt University Recreation Center and its programs. I further acknowledge and accept the rules and procedures concerning the use of the equipment and facilities of the Dordt University Recreation Center.

Prior to participating in activities at the Dordt University Recreation Center, users are encouraged to consult with a medical professional to confirm fitness for participation in activities at the Dordt University Recreation Center. I certify that I am in good health and have no physical, medical, mental, or emotional impairments, conditions or concerns that might jeopardize or affect my safety, or the safety of others, related to my participation in activities at the Dordt University Recreation Center. If I have a prescription for medications or am taking over the counter medications, I understand that I should confirm with my medical provider whether the medications will impact my participation in activities at the Dordt University Recreation Center. I understand that I should not participate in activities at the Dordt University Recreation Center while under the influence of any medication that may impact my ability to safely participate.

I understand that neither Dordt University, nor its employees, serve as guardians or insurers of my safety. Dordt University does not provide any special insurance for my protection, and it is my responsibility to obtain any appropriate insurance. I agree that all expenses arising from an accident or injury to myself or my property, including but not limited to, emergency transport; emergency medical services; medical treatment; and damage or loss to property are my responsibilities. I have obtained and agree to use my personal medical insurance as primary medical coverage if an accident or injury occurs.

I agree to notify supervisory Dordt University Recreation Center employee(s)/staff member(s) of any existing medical condition or medication that could affect my ability to fully participate in activities. If any medical attention is needed, and I am unable to provide consent on my own behalf, I consent to emergency medical treatment and grant Dordt University and its employee’s full authority to take whatever actions they may consider to be warranted under the circumstances concerning my health and safety. This includes, but is not limited to, the authority and permission to arrange/provide transportation, approval for a hospital, medical treatment facility, and/or health care provider to provide medical exams, testing, medical treatment, and any medical procedures immediately necessary and advisable in the interest of my health and well-being, all at my expense.

I grant full permission for Dordt University to use any photographs, recordings, or any other record of my activities at the Dordt University Recreation Center for any purpose. I certify that I am over the age of 18 and legally competent to sign this form. I understand that this document constitutes a legally binding contract. I have completely read, understand, and voluntarily accept the terms of this agreement.


THE PHYSICAL ACTIVITY READINESS QUESTIONNAIRE

Being physically active is very safe for most people. Some people, however, should check with their doctors before they increase their current level of activity. The PAR-Q has been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.
ANSWER YES OR NO TO THE FOLLOWING

If you answered yes:

If you answered yes to one or more questions, are older than age 40 and have been inactive or are concerned about your health, consult a physician before taking a fitness test or substantially increasing your physical activity. You should ask for a medical clearance along with information about specific exercise limitations you may have.

In most cases, you will still be able to do any type of activity you want as long as you adhere to some guidelines.

If you answered no:

If you answered “No” to all the PAR-Q questions, you can be reasonably sure that you can exercise safely and have low risk of having any medical complications from exercise. It is still important to start slowly and increase gradually. It may also be helpful to have a fitness assessment with a personal trainer or coach in order to determine where to begin

When to delay the start of an exercise program:

  • If you are not feeling well because of a temporary illness, such as a cold or a fever, wait until you feel better to begin exercising.
  • If you are or may be pregnant, talk with your doctor before you start becoming more active.

I have read, understand and answered this questionnaire to the best of my ability and knowledge.

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