FACILITY USAGE AND LIABILITY USAGE
Last Name ______________________________First____________
Address - local or campus ______________________________________
Phone________________________________Email___________________ Expiration _________ receipt #__________
Renewal Expiration: ______________ ________________ ______________ ____________ _____________
Receipt #
Community/Clarion Employee - payroll deduction is available now
Card Issued: ______________ Amount paid:__________ (Check or $)
Employees must use Clarion ID for entry a card will not be given out.
Liability:
I, the undersigned, voluntarily assume all risks of injury while using the Recreation Center's equipment and facilities.
The possible risks associated with physical activity include but are not limited to muscle strain, shin splints, broken bones,
heart related illnesses, abnormal blood pressure and in rare instances heart attack.
Additional Responsibilities
I agree to abide by all of the rules and regulations that govern the facility, these rules and regulations are posted in the center.
I will properly identify myself. I am aware that I am to bring my ID to use the facility. Replacement IDs will cost $5.00.
I understand that I am responsible for personal articles lost or stolen in the Recreation Center. The hours are subject to change and we reserve the right to close when students are not in session. At times the courts and wall area may be unavailable.
The recreation center web page has the most current information. www.clarion.edu/reccenter.
Facilities and services will be available on a regular basis, however they may be discontinued for a given period of time because of directives from the University, major maintenance projects, or other unforeseen circumstances. Memberships are not prorated because of these events.
-Memberships are not transferable nor are they refundable.
-Misuse of memberships or facilities may result in the membership being revoked.
Waiver of Liability
I voluntarily waive any and all claims of injury against the University, its trustees, officers, employees, and staff.
I hereby certify that I have read the above agreement.
__________________ ____________________ _______________
MEMBER SIGNATURE DATE
