'Blazer Blast 2026

I do hereby state that I am the parent or legal guardian for the above-named minor(s), and in consideration of my minor(s) being permitted to participate in the Activity at Utah Tech University, I agree to the following:

Assumption of Risk: I understand that engaging in any form of physical activity could pose a serious risk to my minor’s health or cause death and that this risk is in part dependent on my minor’s particular level of fitness, medical condition and exercise choices. I understand that my minor’s participation in this Activity and/or use of Utah Tech campus facilities, involves risks and my minor assumes the risks, including but not limited to: physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and/or death. I understand that these injuries or outcomes may arise from my minor’s own or other’s actions, inaction, or negligence or the condition of Utah Tech campus facilities and/or equipment. My minor assumes all related risks, both known and unknown to me or my minor, related to my minor’s participation in this Activity and/or use of Utah Tech campus facilities. I further agree to accept all Utah Tech campus facility requirements for use of the facility and my minor agrees to follow the instructions given by supervisory personnel at Utah Tech campus facilities. Risks involved in the swimming pool include, but are not limited to: slipping, falling, panic, drowning, and dangerous acts of others. Risks involved in HPC/Climbing Wall use include, but are not limited to: slips, falls, cuts, scrapes, lacerations, burns, sprains, tears, concussions, bone fractures, bleeding, bruising, hemorrhage, infection, pain, nausea, dizziness, or other illness or sickness. I am voluntarily allowing my minor to participate in this Activity and my minor may be using Utah Tech campus facilities and I acknowledge and fully assume the risks associated with my minor’s participation and use of Utah Tech campus facilities.

Physical Health Considerations: I understand it is strongly recommended that I first consult a physician to establish whether it is appropriate for my minor to participate in this Activity. Further, I agree that if I, or my minor, notice any change in my minor’s physical condition that could indicate a health risk if my minor continues to participate, I will promptly have my minor consult a physician and follow my physician’s recommendations about my minor’s continued participation in this Activity.

Health Certification: I certify that my minor is physically capable and sufficiently healthy to be engaging in this Activity, both mentally and physically, and that my minor has no health care condition which would interfere with my minor’s ability to safely participate.

Emergency: I agree that if emergency conditions arise and I am unable to give my consent for emergency treatment or care, that the staff or personnel of Utah Tech, any ambulance or hospital emergency room doctors, nurses, and technicians may render appropriate treatment until I or the emergency contact, can give consent for further treatment. Consent is expressly given, in the event of injury, for any emergency aid, anesthesia and/or operation, if, in the opinion of the attending physician, such treatment is necessary. I further authorize the University and its representatives to discuss my emergency condition, including any Health Insurance Portability and Accountability Act (HIPAA) information and/or Family Educational Rights and Privacy Act (FERPA) information, with my Emergency Contact.

Utah Tech University Rules and Policies: I understand it is my minor’s responsibility to read, become familiar with, and follow the Utah Tech campus facilities standards, rules, policies and regulations and to comply with the etiquette standards, rules, and regulations of Utah Tech University. My minor will also follow all posted rules; which Utah Tech may change from time to time. If my minor violates any Utah Tech rule, my minor assumes all risk of injury, illness, damage or loss to my minor or property or to Utah Tech property. I understand that my minor’s failure to follow all Utah Tech rules may result in the revocation of my minor’s right to participate in this Activity. I further agree that my minor will abide by all posted club or event rules or the specific direction, training or recommendation of club or event advisors and staff, and I assume all liability for any accident, injury, sickness or death as a direct or indirect result of any club or event activity, which occurs as a result of my minor’s participation.

Indemnification and Hold Harmless: I agree to indemnify and hold the State of Utah and Utah Tech University, its Board of Trustees, administrators, directors, officers, employees, and agents (collectively referred to as “Utah Tech”) harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, arising out of my minor’s participation in this Activity and/or use of Utah Tech campus facilities and agree to reimburse Utah Tech for any such expenses incurred.

Release of Liability and Waiver: In return for my minor being permitted to participate in this Activity, and for being permitted to use Utah Tech campus facilities, including any associated use of the premises, facilities, staff, equipment, and services of Utah Tech facilities or Utah Tech, I, for myself, heirs, personal representatives, and assigns, do hereby release, waive, discharge, and promise not to sue Utah Tech University, its Board of Trustees, administrators, directors, officers, employees, and/or agents (collectively referred to as “Utah Tech”) from liability from any and all claims, including the negligence of Utah Tech, resulting in personal injury (including death), accidents or illnesses, and property loss in connection with my minor’s participation in the Activity and/or use of Utah Tech campus facilities.

Photo Release: Participants in Utah Tech events are sometimes photographed and videotaped for use in Utah Tech promotional and educational materials. I authorize Utah Tech to record and photograph my image and/or that of my minor for use by Utah Tech or its assignees in research, educational and promotional programs. I understand any audio, video, film and/or print images may be edited, duplicated, distributed, reproduced, broadcast, and/or reformatted in any form and manner without payment of fees.

Binding Effect: This waiver shall be binding upon my relatives, personal representatives, heirs, beneficiaries, next of kin, or assigns and shall inure to the benefit of the University and its respective successors and assigns.

Invalidity/Unenforceability: If any provision of this waiver is found by a court of competent jurisdiction to be invalid, illegal, or unenforceable, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this waiver or invalidate or render unenforceable such term or provision in any other jurisdiction.

Governing Law and Severability: I understand that if any portion of this waiver is held to be invalid or unenforceable, I will continue to be bound by the remaining terms. I agree that this waiver shall be governed by the laws of the State of Utah, and any disputes arising out of or in connection with this waiver shall be under the exclusive jurisdiction of the courts in Washington County, Utah.

Understanding and Acknowledgement: I acknowledge that I am aware of potential risks related to my minor’s participation in the Activity and/or in my minor’s use of Utah Tech campus facilities and understand that I am giving up substantial rights, including my right to sue. I acknowledge my minor’s participation and use of Utah Tech campus facilities is voluntary, that my minor and I knowingly assume all such risks, and that I am signing this waiver freely and voluntarily. I am 18 years of age or older. I have read this waiver and fully and completely understand the potential risks that may be associated with the Activity.

Signature: By typing below, I signify that I have read, understand and agree to the terms of this waiver. I also expressly agree and accept that this waiver may be executed through the use of electronic signature, including a typed signature, which I acknowledge is a lawful means of obtaining signatures. I agree that my typed signature is the legal equivalent of my manual signature on this waiver. I also certify that I am over the age of 18.