CSCC Athletics Department

Columbus State Community College - Athletic Waiver Form

I am aware that playing or practicing in any sport can be a dangerous activity involving many risks or injury. I understand that the dangers and risks of playing or practicing in the sport listed below include, but are not limited to, death, serious neck and spinal injuries which may result in complete or partial paralysis or brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the musculoskeletal system and serious injury or impairment to other aspects of my body, general health and well being.

Because of the dangers of participation in the below sport, I recognize the importance of the coach's instructions regarding playing techniques, training, rules of the sport, or to the team rules, and to obey those instructions.

In consideration of Columbus State Community College permitting me to practice, play or tryout for CSCC's (indicate sport)_______________________________ team, and to engage in all activities related to the team, including practicing, playing and travel. I hereby voluntarily assume all risks associated with participation and agree to exonerate and save harmless CSCC, their agents, servants, employees, the CSCC athletic staff, the physicians, athletic trainers, and other practitioners of the healing arts treating me, from any and all liability, claims, causes of action or demands of any kind and nature whatsoever which may arise by or in connection with my participation in any activities related to the CSCC______________________ team,

The terms hereof shall serve as a release and assumption of risks for my heirs, estate, executor, administrator, assignees, and all members of my family.

I hereby agree to submit any disputes that may arise between myself and CSCC, its agents, servants, employees, CSCC athletic staff, physicians, athletic trainers, and other practitioners of the healing arts treating me, and all their agents, trustees, servants, and employees, in connection with my activities at CSCC, to binding arbitration before three arbitrators, in accordance with the rules of the American Arbitration Association.

Name of Athlete (printed)______________________________________________________

Signature of Athlete________________________________________ Date______________

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