This form outlines the inherent risks of athletic participation at Vincennes University and confirms a student-athlete’s acknowledgment and acceptance of those risks.
Title
A short description to explain the nature of a ticket.
Consent To Participate
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Who is completing this form?

Student Athlete Information

Type the date of birth for the Student-Athlete.
Student-Athlete Cell Number
Student-Athletes Email

Acknowledgments & Consent

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Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment
Please read carefully & understand before you complete the acknowledgment (required)

Inherent Risks of Athletic Participation


Participation in any athletic activity may involve injury. Such injury can include direct physical and possibly crippling injury to one’s body. There is also the possibility of suffering emotional distress or psychological injury because of witnessing or actually inflicting injury to another. The severity of such injury can range from minor cuts, scrapes, bruises, muscle strains, or bone fractures and dislocations to catastrophic injury, such as complete paralysis, or even death. Such injury can impair one’s general physical and mental health and hinder one’s future ability to earn a living, to engage in other business, social, and recreational activities, and generally to enjoy life.

Specific Injury Risks

All sports involve the risks of serious injury or death. These risks of injury include neck and spinal injuries, which can result in complete or partial paralysis; brain damage; eye, dental, hearing and other head injuries; injury to the body’s bones, joints, ligaments, muscles, tendons, and other aspects of the musculoskeletal system. Pre-existing medical conditions, including illness, disease, and prior injuries can be aggravated or cause other injuries while engaged in sports. Use of drugs, alcohol, or medications can contribute to injury or illness while participating in athletic activities. Some injuries may be caused because of poor physical conditioning and overexertion. Such overexertion can result in injury to muscles, the heart, and other body parts, resulting in sprains and strains, cardiac or cardiopulmonary arrest, and other medical conditions. Injuries can also result from the use of correct or incorrect playing techniques used in tryouts, practices, warm-ups, drills, games, plays, or other similar undertakings. Injury can result from misfit or worn equipment and from otherwise wearing and/or using equipment or other protective gear. Injury can result from training room procedures; from the use of training equipment; from the administration of first aid; or from failing to follow game, training, safety or other team rules

Voluntary Participation & Risk Acceptance
I am voluntarily choosing to participate in the activity below and hereby accept full personal responsibility for my own actions and conduct in this activity, including making sure that I know
  • all of the risks and dangers that I may encounter in this activity
  • how to exercise reasonable care to avoid or minimize those risks and dangers.

Your Informed Decision & Responsibility

The purpose of this warning is to aid you in making an informed decision as to whether you (or your child or ward) should participate in this athletic activity and, as a condition of such participation, sign the foregoing acknowledgment of hazards and risks connected with participation in intercollegiate sports. In addition, its purpose is to make you aware that, as a student-athlete (or as a parent or guardian), it is your responsibility to learn about and/or ask coaches, physicians, or other knowledgeable persons about any concerns that you might have at any time regarding athletic safety and participation.
 

Inherent Risks of Athletic Participation
I am aware that the very nature of athletic participation carries with it an inherent risk of injury. I understand that the dangers and risks of participating in athletics, whether in competition or preparing to compete, include, but are not limited to, death, serious neck and spinal injuries which may result in complete or partial paralysis, brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the muscular skeletal system, and serious injury or impairment to other aspects of my body and general health and well-being.
Consent for Emergency Medical Aid
I give my permission and understand that the athletic trainer, coaching staff, team physician, administrators, or other school officials can use their own judgment in applying first aid until medical help becomes available, or to secure medical aid and ambulance service in case parents cannot be reached. I voluntarily accept their service on my behalf and grant permission for them to perform their necessary duties as described above.
Responsibility for Injury Prevention
I also accept the responsibility in taking personal measures to help prevent injury to myself or other athletes by notifying the coaching staff, athletic trainer, administrators or other Vincennes University Athletics personnel of conditions that I am aware of that may predispose me or other athletes to an increased risk of injury resulting from athletic participation.
Assumption of Athletic Risks
Having understood the risks of athletic participation and particularly the risk inherent, I voluntarily assume and accept these risks as they have been explained above.
Attestation
I certify, under penalty of perjury of the laws of the State of Indiana, that I have read the contents and warning of this acknowledgement; that I fully understand this acknowledgment; that I am in agreement with the terms of this acknowledgment; that I am signing this acknowledgement voluntarily, under no compulsion; that I have had an opportunity to ask questions and seek advice regarding this acknowledgement; that I am age 18 or over or, if not, that my parents/guardians hereby make these promises on my behalf; and that I choose to participate (or to permit my child or ward to participate) in the Vincennes University activity listed below of my own accord.
Acknowledgment & Consent
Clicking Submit signifies that you have thoroughly read and fully understand all the information presented in this form. This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.This action is the equivalent of providing your handwritten signature and the current date.

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