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Tostrud Waiver Form
Agreement for Assumption of Risk, Indemnification, Release, and Consent for Emergency Treatment for St. Olaf Community Members
Please select the type of St. Olaf community member you are
St. Olaf Employee, Retiree, or Emeriti - Free
St. Olaf Spouse or Child Over 18 - $120
St. Olaf Alumni [must live in Northfield/Dundas] - $120
St. Olaf Alumni Spouse or Child Over 18 - $120
Bon Appetit Employee at St. Olaf [Employee Only] - Free
Barnes & Noble College Bookstore Employee at St. Olaf [Employee Only] - Free
Your identity, address, and employment status will be verified by St. Olaf before you are allowed access to St. Olaf Recreation Facilities.
I wish to use the St. Olaf College (Tostrud/Skoglund/Tom Porter Hall) Recreation Facilities.
Name of Spouse or Parent working at St. Olaf
Name of your Spouse or Parent who is a St. Olaf Alumni
Your Spouse or Parent's Graduation Year
Do you wish to include children in your membership?
Only children under age 18 may be included on this form. Each child age 5 and up costs $120. Children under 5 are free.
I wish to include my children for membership (under age 18):
There is a $120 fee for each child above the age of 4.
Name of Child
Age of Child
I have read and agree to abide by the guidelines for the use of the Recreation facilities. I am medically fit to participate in the activities I will choose to engage in at the Recreation facilities. I understand that I may use the facilities only at times designated on the recreation program information sheet and that an adult member must accompany children under the age of 18 in the Recreation facilities at all times. I understand that priority is given to St. Olaf College students, faculty, and staff during open recreation hours. I understand that if I do not follow the policies and procedures of the Recreation facilities my recreation pass card may be revoked. St. Olaf has the option of closing areas for special events. I understand that this Assumption of Risk, Indemnification, Release and Consent for Emergency Treatment is intended to be as broad and inclusive as permitted by the laws of the state of Minnesota and I agree that if any portion is held invalid, the remainder will continue in full legal force and effect. I further agree that this Agreement shall be governed by the state of Minnesota.
I UNDERSTAND THAT I AM BEING ASKED TO READ EACH OF THE FOLLOWING PARAGRAPHS CAREFULLY. I UNDERSTAND THAT IF I WISH TO DISCUSS ANY OF THE TERMS CONTAINED IN THIS AGREEMENT, I MAY CONTACT THE VICE PRESIDENT/CFO, AT TELEPHONE NUMBER 507-786-3018.
Assumption of Risks:
I understand that physical activity related Recreation facilities use by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. Some of these involve strenuous exertions of strength using various muscle groups, some involve quick movement involving speed and change of direction, and others involve sustained physical activity, which places stress on the cardiovascular system. The specific risks vary from one activity to another, but in each activity the risks range from: 1) minor injuries such as scratches, bruises, and sprains to 2) major injuries such as fractures, internal injuries, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death. I understand that the College has advised me to seek the advice of my physician before participating in this activity. I understand that I have been advised to have health and accident insurance in effect and that no such coverage is provided for me by the College.
I KNOW, UNDERSTAND, AND APPRECIATE THE RISKS THAT ARE INHERENT IN THE ABOVE-LISTED PROGRAMS AND ACTIVITIES. I HEREBY ASSERT THAT MY PARTICIPATION AND THAT OF MY CHILDREN IS VOLUNTARY AND THAT I KNOWINGLY ASSUME ALL SUCH RISKS.
Assumption of Risks Agreement
I agree to the terms of the "Assumptions of Risk" section above.
Hold Harmless, Indemnity and Release:
In consideration of permission for me to voluntarily use St. Olaf Recreation facilities today and on all future dates, I, for myself, my heirs, personal representatives or assigns, agree to defend, hold harmless, indemnify and release the Board of Regents of St. Olaf College and their officers, employees, agents, and volunteers, from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal injury, or death which may result from my participation in the above-listed program. This release includes claims based on the negligence of the Board of Regents of St. Olaf College, and their officers, employees, agents, and volunteers, but expressly does not include claims based on their intentional misconduct or gross negligence.
I UNDERSTAND THAT BY AGREEING TO THIS CLAUSE I AM RELEASING CLAIMS AND GIVING UP SUBSTANTIAL RIGHTS, INCLUDING MY RIGHT TO SUE.
Hold Harmless, Indemnity and Release Agreement
I agree to the terms of the "Hold Harmless, Indemnity and Release" section above.
Consent for Emergency Treatment:
I authorize St. Olaf College and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered that St. Olaf personnel deem necessary for my safety and protection as well as my children.
I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATION.
Consent for Emergency Treatment
I agree to the terms of the "Consent for Emergency Treatment" section above.
Must bring in proof of address at time of payment.
Address Line 2
State / Province / Region
ZIP / Postal Code
Antigua and Barbuda
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Congo, Democratic Republic of the
Congo, Republic of the
French Southern Territories
Heard and McDonald Islands
Isle of Man
Lao People's Democratic Republic
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Svalbard and Jan Mayen Islands
Trinidad and Tobago
Turks and Caicos Islands
US Minor Outlying Islands
United Arab Emirates
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Number of Children
Cost of Requester
If you have a St. Olaf e-mail address, please enter that one here.
Upon receipt of the signed waiver and paid fees, a recreation ID card will need to be obtained from the Buntrock card office. This pass is for the exclusive use of the person named on the card. Those who have already obtained an ID card from the previous year will have their current card reactivated upon completion of the above. You will be required to scan your recreation pass each time you enter the building.
You must pay before you are able to access the facilities. You may pay with cash or check.
Payment is collected in Skoglund 104 (new location) with Jenny Peterson between the hours of 9 AM - 12 PM Monday through Friday.