Vanderbilt University Athletics Department Camp/Clinic Liability Waiver

hideYou should not enter any sensitive information on this page such as health data, passwords or social security numbers. If you are being asked or need to provide this information for your registration please contact Vanderbilt Women's Lacrosse directly.

Vanderbilt University Athletics Department Camp/Clinic Liability Waiver

The undersigned athletic camp participant (“participant”) (or parent / guardian if participant is
under 18 years of age) understands that I will be engaging in physical activity during the Program,
which contains an inherent risk of physical injury (which could include a serious injury or death)
and the undersigned (for himself/herself in the case participant is an adult or for participant if
participant is a minor) assumes the risk and does release, waive, and hold harmless Vanderbilt
University (“Vanderbilt”), its officers, trustees, agents and employees, including specifically all
persons employed, hired, or otherwise retained by Vanderbilt to conduct the camp for which this
informed consent/participant release applies, from any and all liability or cause of action for
personal injury or property damage arising out of the participant’s participation in the camp
program. I agree to this release in consideration of Vanderbilt offering this opportunity and
allowing me to participate in this Program.
In addition, an inherent risk of exposure to COVID-19 or any infectious disease exists in any public
place where people are present. COVID-19 is highly contagious and can lead to severe illness and
death. Vanderbilt is following public health guidelines to reduce the spread of infection; however,
Vanderbilt cannot guarantee that I will not become infected with COVID-19. I acknowledge that
I cannot be protected from all risk of illness caused by COVID-19. As a participant in the Program,
I voluntarily assume all risks related to exposure to COVID-19 or any infectious disease. I
understand that the rules and regulations of the Program and Vanderbilt are designed for the safety
and protection of all participants and I hereby agree to abide by these rules and regulations.
In the case of a minor participant, I hereby grant permission for the participant to attend the camp
and consent to the participant being treated by a licensed physician or health care professional or
a member of the camp/clinic medical staff in the event of an injury, illness, or other mishap. I
understand and agree that Vanderbilt does not provide any health or liability insurance coverage
for participant and that the undersigned will be financially responsible for any costs of expenses
incurred related to the provision of any medical treatment to participant. In the event that the camp
activity includes transporting a minor participant in a vehicle, I grant permission for the
transporting of the minor participant to and from said camp activity. Any action arising out of
participant’s engagement in the camp and the terms of this release shall be governed by the laws
of the State of Tennessee and any related action shall be brought only in Nashville, Davidson
County, Tennessee.
Vanderbilt Protection of Minors Provision
Vanderbilt University personnel adhere to Tennessee state law on mandatory child abuse reporting
to either the appropriate law enforcement agency or the state hotline operated by the Department
of Children’s Service. In addition to external reporting, Vanderbilt has a mandatory internal child
abuse reporting procedure. If you have reason to believe abuse or inappropriate behavior has
occurred concerning a minor participating in a Vanderbilt University program, please consult the
program director, or Risk Management (615-936-5935), or report via the Vanderbilt Compliance
Hotline at 844-814-5935. The Tennessee Child Abuse reporting hotline number is 877-237-0004.





__________________________________________ __________________
Participant’s Name Participant’s Birthdate

__________________________________________ __________________
Participant or Parent/Guardian Signature if under 18 Date
or cancel