First Name: required
Last Name: required
Preferred Method of Contact:*
Select a contact method...
If you are currently employed by the university, please select "Faculty/Staff" regardless of Alumni status.
Select an affiliation...
How did you hear about the event:
Do you have a health or medical concern that you feel Campus Rec/the organizers of this program should be aware of?*
Select a medical concern...
No, I do not have a health or medical concern that pertains to this program.
Yes. A Campus Rec staff member should contact me to discuss these considerations.
I'm not sure. I would like a Campus Rec staff member to contact me for clarification.
For security reasons, please do NOT disclose your health/medical concern on this form. A Campus Rec staff member will be in contact with you.
I hereby declare, assert and affirm that my participation in the Grand Valley State University Campus Recreation Program is done having voluntarily and knowingly assumed all risks involved in this program. The physical risk(s) associated are those correlated with normal, vigorous physical activity. These risks include, but are not limited to, bodily discomfort and fatigue, muscular soreness, pulled or strained muscles, overuse injuries/soft tissue damage, bodily injury resulting from falls, and the rare instance of abnormal changes/responses of the cardiopulmonary system to exercise. Adverse responses include abnormal blood pressure, heart arrhythmias, and the very rare instance of heart attack, stroke, or sudden death.
In consideration of acceptance of this contract allowing my participation in the above stated Special Event and intending to be legally bound thereby, I hereby for myself, my heirs, executors, administrators and assigns, WAIVE AND RELEASE any and all rights and claims for negligence, injuries, damages or losses that I may incur involved in the above stated Campus Recreation Program, specifically Grand Valley State University, it's respective employees, agents, representatives, successors and assigns for any and all activities connected with the above Special Event. If I am a Grand Valley employee, I also understand that I do hereby WAIVE any and all rights or benefits under the State of Michigan Worker's Compensation laws for any injury incurred as a result of my participation in this Special Event.
1 Campus Drive
Lower Level Rec Center
Monday- Wednesday 10:00am - 9:00pm
Thursday 10:00am - 9:00pm
Friday 10:00am - 4:00pm