General Conditions of Use

Page 1

University Student Center - General Conditions of Use

Contact Information - First Name
Contact Information - Middle Initial
Contact Information - Last Name
Contact Information - Email Address
Contact Information - Phone Number
Contact Information - Address
Contact Information - City
Contact Information - State
Contact Information - Zip Code
Birth Date*
Emergency Contact Name
Relationship
Emergency Contact Number
Payment Received

*For Alumni, Employees or Contracted Vendors Note whether paid in cash or check. If check, include Check No.
Approved By

I.          POLICY

Any Point Park University (the “University”), alumni, employee or contracted vendor (“Participant”) will be allowed to use the University Student Center facilities (“Facility”) pursuant to the guidelines listed below:

1. All Participants must complete and sign this document

2. All Participants must obtain an ID Card from the Office of Public Safety located on the 3rd Floor of Frontier Hall.  The ID Card must be carried at all times while in the facility.  The ID card is non-transferrable and replacement cards will be issued with a $25 replacement charge.

3. All Participants must adhere to the Facility schedule.  There will be times during the year that the Facility or part of the Facility is not accessible.  An updated schedule is available at the control desk.

4. The Participants or his/her Guardian (if Participant is a Minor) will execute the Emergency Contact, Medical Information, and Consent to Treat Form, which is attached hereto as Exhibit A.  Failure to execute the Consent to Treat Form will result in termination of the Participant from the Program.

5. Participants may be invited to participate in certain fitness classes, subject to paying any applicable fee, executing a separate participation agreement, class size, availability and other factors.  Membership does not give Participants the right to participate in these classes.

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*If Participant is under the age of 18, Participant and Participant's Legal Guardian must execute this document. Guardian acknowledges that Guardian is signing on behalf of Participant and on behalf of Guardian and knowingly waives Guardian's and Participant's rights to bring any claims against the University and knowingly releases the University from any claims related, in any way, to the use of the Facility.

User Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

II.        CONDITIONS OF USE

Point Park University (the “University”) imposes the following conditions upon use of the Facility, including all equipment, fixtures and items contained in the Facility (“Facility”).  Failure to comply with these conditions is a breach of this agreement and will result in the loss of Participant’s privilege to use the Facility or any other facility owned, operated or controlled by the University.  If Participant’s membership is terminated, Participant acknowledges that he or she is not entitled to a refund of any fee paid.  Participant acknowledges that use of the Facility requires good health, fitness, skill, concentration, awareness of surroundings and can be HAZARDOUS AND PRESENT A DANGER to Participant.  Participant believes and represents that Participant is qualified to use the Facility and is familiar with all safety laws, regulations and instructions relating to using the Facility and equipment contained therein.  Moreover, Participant agrees that, if at any time Participant believes it is not safe to use the Facility, Participant will immediately discontinue use of the Facility.  In addition, Participant expressly agrees that:

1. The University makes no warranty, either expressed or implied, as to the condition, fitness, merchantability or suitability of the Facility for Participant’s purpose or needs;

2. Participant has had the opportunity to inspect the Facility and to become acquainted with the condition of the facility, and has, in fact, done so;

3. Participant will not make any unlawful or offensive use of the Facility;

4. Participant will not make unwanted advances toward or initiate an unwanted conversation with other users of the Facility;

5. Participant will not take any photographs of others at the Facility, unless expressly authorized to do so;

6. Participant will wear appropriate gym clothing that does not contain offensive language

7. Participant will wear tennis shoes (no sandals or flip flops);

8.Participant will not participate in any "horseplay" while in the facility;

9.Follow all other rules and regulations of the Student Center, which are available upon request.

User Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

III.       CONSENT TO FULLY RELEASE UNIVERSITY FROM CLAIMS

A.        DISCLAIMER

Participant and Guardian (if Participant is a Minor) understand and acknowledge that Point Park University, its principals, directors, officers, agents, employees, members and volunteers (the “University”) are not responsible for any injury, death, loss, theft, or damage sustained by Participant while using the Facility, however caused, including by the negligence of the University.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

B.        ACKNOWLEDGMENT OF RISKS

Participant and Guardian (if Participant is a Minor) have reviewed the Facility, the physical environment and conditions of the Facility and this Agreement and understand and approve the anticipated activities of Participant in the Facility.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

Participant and Guardian (if is a Minor) acknowledge that they are familiar with the activities that Participant may participate in while using the Facility, which include, but are not limited to, weight lifting, running, using exercise equipment, engaging in sporting activities.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

Participant and Guardian (if Participant is a Minor) acknowledge that they understand the risks, dangers, and hazards associated with Participant’s use of the Facility, including, without limitation the risk of severe or fatal injury to Participant and others, including, but not limited to, the risks stated in this Agreement.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

C.        ASSUMPTION OF RISKS

Participant and Guardian (if Participant is a Minor) acknowledge that use of the Facility requires good health and fitness and can be HAZARDOUS AND PRESENT A DANGER to Participant.  Participant and Guardian believe and represent that Participant is qualified to use the Facility and that if at any time Participant believes the conditions of the Facility to be unsafe, Participant will immediately discontinue further use of the Facility

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

In recognition of the inherent risks of which Participant will engage in while using the Facility, Participant and Guardian voluntarily assume the Participant’s risk by choosing to participate/allowing Minor Participant to use the Facility. Participant and Guardian understand that the University does not assume any risk or liability due to Participant’s use of the Facility. These risks include, but are not limited to, the following:

1.         The risks and hazards associated with Participant’s use of the Facility including, falls, collisions, missteps, and other mishaps; flaws and defects in equipment and facilities; irregular facility conditions; negligent facility maintenance.  Risks may be caused by Participant’s own action or inaction, the actions or inactions of other participants, the actions or inactions of spectators, the condition of the Facility in which the Program takes place and/or the negligence of the University.  Some risks cannot be predicted or controlled.  There may be other risks and social and economic losses either not known to the University, Participant or Guardian or are not readily foreseeable at this time.  Participant and Guardian voluntarily assume all of these risks.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

2.         The risks associated with use of the Facility or as a result of any natural disaster, extreme weather condition or event, or any other occurrence during Participant’s use of the Facility, natural or otherwise.  The potential injuries that could result from use of the Facility include, without limitation, broken bones, soft tissue damage, stress put on joints, muscles, and other body parts, torn muscles and/or ligaments, sprains, posture, hip and knee injuries, emotional distress, eye damage, cuts, wounds, scrapes, abrasions, and/or spinal injuries, shock, electrocution, By entering your initials, you agree to the terms and conditions in this document.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

3.         Theft or loss of personal property during the use of the Facility.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

IV.       INDEMNIFICATION AND RELEASE OF LIABILITY

In consideration of the University granting Participant permission to use the Facility, Participant agrees:

1.         TO ASSUME AND ACCEPT ALL RISKS arising out of, associated with, or related to Participant’s operation or use of the Facility, even though such risks may have been caused by the negligence of the University.  This assumption and acceptance of all risks includes, without limitation, any medical expenses that Participant may incur as a result of Rider’s personal injury or illness.

2.         TO BE SOLELY RESPONSIBLE FOR ANY INJURY, LOSS, OR DAMAGE which Participant  might sustain while using the Facility, even though such injury, loss, or damage may have been caused by negligence of the University.

3.         TO REMISE, RELEASE AND FOREVER DISCHARGE the University, its principals, directors, officers, agents, employees, members and volunteers, and each and every land owner, municipal and/or government agency upon whose property the equipment is operated or used, from all liability, actions, causes of action, suits, judgments, claims and demands and FOREVER WAIVE any claim for damage arising from any cause whatsoever even though such liability, actions, causes of action, suits, judgments, claims and demands may have been caused by the negligence of the University and/or its principals, directors, officers, agents employees and volunteers.

4.         TO PROVIDE LEGAL DEFENSE, INDEMNIFY AND HOLD HARMLESS and free from liability University, its principals, directors, officers, agents, employees, members and volunteers, from and against any and all claims for damages, demands, costs or expenses which User shall become obligated to pay by reason of liability imposed by law because of injury to property or injury to or death of persons suffered by reason of any act, omission or negligence of Participant or arising from any accident or injury in connection with or attributable to the use of the Facility by Participant.

Participant Initial Here

By entering your initials, you agree to the terms and conditions in this document.
Guardian Initial Here

By entering your initials, you agree to the terms and conditions in this document.

IMPORTANT – READ THE ENTIRE AGREEMENT BEFORE SIGNING.

I HAVE CAREFULLY READ THE ABOVE AGREEMENT, AND FULLY RECOGNIZE, UNDERSTAND AND AGREE TO THE TERMS, CONDITIONS AND RISKS SET FORTH IN THIS AGREEMENT.
 
I ACKNOWLEDGE THAT I AM SIGNING THIS AGREEMENT FREELY AND VOLUNTARILY, WITH THE INTENT TO BE LEGALLY BOUND, AND THAT I INTEND MY SIGNATURE BELOW TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY FOR ANY AND ALL NEGLIGENT ACTIONS AGAINST THE UNIVERSITY AND THAT I AM GIVING UP MY RIGHT TO SUE THE UNIVERSITY FOR NEGLIGENCE.  I UNDERSTAND THAT, IF THE TERMS OF THIS AGREEMENT ARE UNACCEPTABLE TO ME, I SHOULD NOT USE THE FACILITY.

Signature of Participant
Date
Signature of Guardian

If over 18 years old type N/A
Date

EMERGENCY CONTACT, MEDICAL INFORMATION, AND CONSENT TO TREAT FORM

Participant Contact Information - First Name
Participant Contact Information - Middle Initial
Participant Contact Information - Last Name
Participant Contact Information - Email Address
Participant Contact Information - Phone Number
Participant Contact Information - Address
Participant Contact Information - City
Participant Contact Information - State
Participant Contact Information - Zip Code
Emergency Contact Information - First Name
Emergency Contact Information - Middle Initial
Emergency Contact Information - Last Name
Emergency Contact Information - Email Address
Emergency Contact Information - Phone Number
Emergency Contact Information - Address
Emergency Contact Information - City
Emergency Contact Information - State
Emergency Contact Information - Zip Code
Relationship to Participant

PERTINENT MEDICAL HISTORY OF PARTICIPANT INCLUDING PREVIOUS INJURIES, PHYSICAL WEAKNESS OR MEDICAL CONCERNS:

Allergies (Food/Medicine/Environmental)

List all allergies
Accessibility Needs
Medications/Prescriptions taken and dosage
Injuries/Medical Conditions

MEDICAL INSURANCE

Insurance Carrier
Carrier Phone
Company Address
Policy/Group Numbers

I give my permission for me/Minor to receive emergency medical treatment as deemed necessary/advisable by an employee, faculty member or agent of Point Park University at a hospital, clinic, urgent care facility, physician’s office or other similar facility and authorize the release of any available medical information as necessary to facilitate such treatment.  Any medical expenses that I/Guardian may incur due to personal injury or illness are my/Guardian’s financial responsibility and not that of the University.  I understand and acknowledge that neither the nurse nor any other member of the University’s staff are permitted to store, dispense or administer any medicines.

Participant Signature

By entering your full name, you agree to the terms and conditions in this document.
Date
Guardian's Signature

By entering your full name, you agree to the terms and conditions in this document.
Date