Work Smart, Play Well! Duke Recreation and Physical Education Crisis Management Manual Risk Management Committee: Mike Forbes, Jeremy Fritz, Janis Hampton, Matt Holdren, Mike Howard, Nathan McKinnis, Meghan Weiseman, Steven McCune, Lisa Wright Edited By Steven McCune
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Duke Recreation and Physical Education Crisis Management Manual First Edition
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Work Smart, Play Well!
Duke Recreation and Physical Education
Crisis Management Manual
Risk Management Committee:
Mike Forbes, Jeremy Fritz, Janis Hampton, Matt Holdren,
Mike Howard, Nathan McKinnis, Meghan Weiseman, Steven McCune, Lisa Wright
Edited By Steven McCune
1
Contents Bylaws of Risk Management Committee ............................................................................................................... 3
Chemical Injury .................................................................................................................................................. 9
Fire ...................................................................................................................................................................... 9
Heart Attack and Stroke ...................................................................................................................................... 9
Power Outage .................................................................................................................................................... 10
First Aid Kit Protocol and Content ....................................................................................................................... 11
Emergency Evacuation Information ..................................................................................................................... 12
Emergency Exits for Wilson Recreation Center ............................................................................................... 12
Emergency Exits for Brodie Recreation Center................................................................................................ 13
Emergency Response Equipment Location by Facility ........................................................................................ 14
Wilson Recreational Center .............................................................................................................................. 14
Taishoff Aquatics Center .................................................................................................................................. 17
Card Gym Basketball Court/Team Store Area ................................................................................................. 18
IM Building ....................................................................................................................................................... 19
Brodie Recreation Center .................................................................................................................................. 19
Employee Information .......................................................................................................................................... 22
Workers’ Rights and Responsibilities ............................................................................................................... 22
Communication Logging .................................................................................................................................. 37
Guest Speakers and Training ............................................................................................................................ 37
Appendix of Facility Maps ................................................................................................................................... 38
Index ..................................................................................................................................................................... 47
3
Bylaws of Risk Management Committee
Whereas, this manual provides logistical plans and resources to better help first responders deal with incidents
and emergencies as they may arise.
Whereas, the safety of patrons and employees is the absolute intent of this plan.
Whereas, the body of knowledge contained within is not complete, and this manual requires an ongoing update
based on new ideas and experiences of those who are charged to oversee it.
Therefore, be it resolved that the committee members appointed each term are responsible for the evolution and
innovation of this living document.
Be it further resolved, the following sections outline the expectations, action plans and appendices to guide the
department to a safer environment for those students and members who chose our programs and facilities for
recreation and education.
4
Meeting Procedures
The risk management committee shall be comprised of a representative from each program/facility area and
shall be headed by a risk management chair.
The risk management chair shall work with each committee member to equally delegate all tasks associated
with the responsibilities of the team.
A secretary/scribe should record all meeting minutes and share the minutes to each member following the
meeting.
The risk committee shall meet every month on a day and time that is most convenient for all team members.
The last meeting before each semester, the committee shall submit and update any changes to the risk manual.
Change is not mandatory but evolution is encouraged to demonstrate the living nature of this document.
Amendments to this document shall include the amendment date in parenthesis at the end of the paragraph
being amended. i.e. (Amended 9/12/12).
Any amendments to the manual shall then be disseminated to the entire staff at a time selected by the risk
management committee. General amendments will be delivered to the staff before all staff trainings which
typically take place at the beginning of the fall and spring academic semesters. Amendments deemed critical in
mitigating risk can be made effective immediately and at the discretion of the risk management committee.
It is the ethical responsibility of all risk managers, no matter the severity, to report and mitigate risk as soon as
the risk is discovered.
5
Definitions ABC’s of CPR- Airway, Breathing, Circulation
Automatic External Defibrillator (AED)- a portable defibrillator designed to be automated such that it can be
used by persons without substantial medical training who are responding to a cardiac emergency.
Cardio Pulmonary Resuscitation (CPR)- emergency procedure for reviving heart and lung function, involving
special physical techniques and often the use of electrical and mechanical equipment
Confidentiality- carried out or revealed in the expectation that anything done or revealed will be kept private
Crisis Management Manual- a systems approach written plan which is used to foresee and mitigate risk and
liability. This plan also provides detailed directions for action in emergencies and incidents which may take
place in the facility and surrounding space.
Duty to Act- each and every professional has the duty to act within the parameters of his/her own training.
Documentation- documents provided or collected together as evidence or as reference material. It is a record of
all aspects of injury/incident. “Who, what, when, where, why and how”. Proper documentation is important in
a court of law.
Emergency Action Plan (EAP)- The purpose of an EAP is to facilitate and organize employer and employee
actions during workplace emergencies
Emergency Medical Service (EMS)- a network of services coordinated to provide aid and medical assistance
from primary response to definitive care, involving personnel trained in the rescue, stabilization, transportation,
and advanced treatment of traumatic or medical emergencies.
Foreseeability- reasonable anticipation of the possible results of an action, such as what may happen if one is
negligent or consequential damages resulting a from breach of a contract
Incident- any event or occurrence both having to do with non-injury and injury and/or death or that is likely to
cause serious problems.
Liability- legal responsibility for something, especially costs or damages
Mitigate- to reduce the harmful effects of something
Occupational Safety and Hazard Association (OSHA)- an organization that provides standards for employers to
maintain a workplace free of hazards.
Personal Protective Equipment (PPE)- barriers used to protect against bloodborne pathogen transmission
Programmatic Hazard- those risks associated at the training level of staff development of improper training
that can lead to accident, injury or death due to negligence.
Negligence- a civil wrong tort causing injury or harm to another person or to property as the result of doing
something or failing to provide a proper or reasonable level of care
Risk- a probability that may cause accident, injury, death or financial damages to a person or facility.
6
Risk management- the reduction of those probabilities that may cause injury, death or financial damages
through an active search and mitigation of those foreseen hazards.
Standard of Care- industry and regulatory commissions provide specific guidelines which are to followed to
ensure a quality and safe environment for participants. Each recreation professional has an obligation to hold
the recreation department to these standards at all times.
7
Emergency Action Plans
Recreation Staff members ~Lay Responders~ are not required to provide care in emergency.
In the event of ANY emergency employees should:
1. Recognize if someone needs immediate help
2. Activate the EAP for the given emergency
a. Call EMS in the event of injury or life-threatening emergency
3. Follow general procedures for emergencies on land
Land Emergencies
Size up the scene, approach victim
Obtain consent from victim
Provide emergency care as needed
o Follow steps for initial assessment
o Summon EMS, if needed
o Perform secondary assessment
4. Red Cross Certified staff may assist members in the emergency throughout the facility
a. Assist with rescue
b. Provide secondary care
c. Clear the facility
d. Retrieve medical equipment
e. Call EMS
5. The chain of command is notified
a. Notify supervisor/facility manager
b. In the case of serious injury/death, notify appropriate managers
c. The supervisor will contact the victim’s family
6. Interview all witnesses
a. As soon as possible ask questions
b. Conduct interview privately and document them in writing
7. Document incidents by completing appropriate reports
a. Responding staff fills out incident report form.
b. All other staff involved must also document the form
8. Check all equipment for damage, restock medical supply kit
a. Clean up any potentially infectious fluids using bodily fluid cleanup kit
b. Use appropriate disinfectant such as bleach (found on pool deck).
c. Wash hands thoroughly before returning to work
9. Complete post-incident evaluation
a. Perform an after action review on what was good/bad
b. Plan better for next time
c. Repair or close any dangerous areas
d. Use experience to better the team
10. Follow-up staff discussion
8
a. Crisis counseling opportunities should be communicated to staff responder to address Critical
Incident Stress
Upon Entering the Scene of an Emergency Size up the scene
A. Check for hazards that could present danger to you and victim
B. Determine what caused injury
C. Determine the number of victims- prioritize care
D. Determine if additional help is needed.
E. Put on personal protective equipment
Begin primary assessment
A. Obtain consent if victim is conscious
B. Summon Emergency Medical Service
Perform secondary assessment to determine any other life threating illness
A. Provide care for conditions found
B. Complete incident report form, advise victim and if possible, release the victim.
9
Crisis Scenarios
Allergic reaction
1. Activate the EAP
2. Help victim administer Epi pen if on hand
3. Make the victim comfortable in a seated position
4. Monitor the victims ABC’s
Chemical Injury
1. Determine if the scene is safe
2. Perform initial assessment & Summon EMS
3. Perform secondary assessment
4. BRUSH dry chemical off of skin
5. Flush skin and eyes with water for at least 20 minutes or until help arrives
6. If ingested call 911 and seek treatment steps.
Cold-related emergency
1. Gently move the victim to warm place
2. Monitor the ABC’s
3. Give rescue breathing if needed
4. Remove wet clothing
5. Warm victim with blankets, foil blanket.
6. NO CAFFEINE
7. Use hot-water bottles wrapped in cloth
Electrocution
1. Determine if the scene is safe
2. Perform initial assessment & Summon EMS
3. Perform secondary assessment
4. Treat any burns or injuries
5. Monitor ABC’s until help arrives
Fire
1. Direct patrons to exit through the appropriate exit points and report to sidewalk in front of Tennis
Courts (West) and other side of parking lot (East)
2. Wait for the all-clear.
Heart Attack and Stroke
1. Upon sizing up the scene call 911 and order the AED
2. Begin initial assessment
a. If victim is alert, have them relax
b. In case of stroke, Act FAST: Face, Arm, Speech, Time
c. If victim becomes unconscious begin the process of CPR.
10
i. Attach AED when available
ii. Continue treatment until help arrives
Heat-related emergency
1. Move victim to cool place
2. Loosen tight clothing
3. Remove perspiration-soaked clothing
4. Apply cool, wet towels to skin
5. Fan the victim
6. Small amounts of cool water
7. If heat stroke is suspected, rapid cooling with cold water emersion
8. Treat for shock- never raise the legs
Power Outage
1. Emergency lights will activate
2. Wait for instruction from Building Supervisor
Seizure
1. Summon EMS if seizure is not typical of victim,
2. Last more than 5 minutes or in water, or multiple episodes
3. Do not attempt to touch the victim
4. Move objects which may hurt the victim
5. Treat for shock, monitor the victims ABC’s until help arrives
Tornado
1. Campus emergency siren will sound. Emergency system text message, sent.
2. Quickly direct all patrons to the nearest locker room.
3. Have patrons duck and cover with their head against the wall.
4. Ensure that a proper head count is done of all members and employees.
5. Treat any injuries as needed.
6. Wait for the all clear.
3.
Violent Crime
1. Summon Duke EMS/Police Immediately
2. If possible, move members away from the area.
3. Keep clear of the violence.
4. Allow EMS/Police to respond accordingly.
DO NOT ATTEMPT TO CONTROL THE ASSAILANT
11
First Aid Kit Protocol and Content
The following content will be provided in all medical kits throughout Duke Recreation and Physical
Education Facilities. Program specific medical supplies may also be supplemented in addition to the
supplies listed below. For refilling kits, contact Zee Medical.
Ice bags will be available at the front desk of the Wilson Center, front desk of the Brodie Center, and in the
First Aid Lockers located on the turf fields on East, West, and Central Campus.
Zee Medical- Soft Side Med Kit- $116.87
1-Tape, Plastic, 2" x 5 yd, 3-Cut spool - 1 ea
1- Eye Wash, Sterile, 4-oz. - 1 ea
1- Eye & Skin Buffered Flushing Sol., 8-oz.
1 box- Bndg, Non-Latex Sheer Strip, Xlg, 25
1 box- Bndg, Non-Latex Dura-Strip, 1", 100
1- Compress, Multi-Trauma Sterile, 10"x30"
2- Dressing, Sterile, 5" x 9"
1- Bandage, Elastic , 3" x 5 yds
1 box- Gauze Pads, 4" x 4". 10/bx
2- Elastic Roller Gauze NS, 3" x 4.5 yd
1- Emergency First Aid Guide
1- Ice Pack, Deluxe, Small
1- Bandage, Triangular 40" NS, 1/unit
1- 3-1 Antibiotic Ointment, 6/unit
1- Clean Wipes, Alcohol Swabs, 10/unit
1- Water-Jel, Burn-Jel, 6/unit
1- Eye Pads w/Adh. Strips, 2/unit
1- Nitrile Gloves, 2 pr/bg
1- PAM II (Protective Airway Mask)
1- Bndg, Kerlix, Sterile 4-1/2" x 4-1/2 yds
1- Scissors, Emergency
1- Soft-Side First Aid Kit Bag, Empty
1- QR Wound Seal, Single Pack
12
Emergency Evacuation Information
Emergency Exits for Wilson Recreation Center
There will be four primary exits used during a situation requiring emergency evacuation of the Wilson
Recreation center. (See Map in Appendix)
The front/main entrance (Exit 4)
The exit from the basketball courts towards the front of the building (Exit 3)
The exit next to the climbing wall (Exit 2)
The exit from the swimming offices (Exit 1)
Recreation and Physical Education employees will be our designated representatives for each exit point.
The life guards will sweep the pool and direct people to the exit by swimming offices (Exit 1).
Facility Monitor sweeps both locker rooms and lower floor, up one floor on the middle stair case,
and then out Exit 2 (by climbing wall)
Facility Monitor then performs a sweep of the climbing wall floor, including classrooms, and
sends patrons out Exit 2 (by climbing wall)
Weight room attendant sweeps weight room and restrooms down the hall to the right and up the
spiral stairs out Exit 3 (from basketball courts)
Weight Room attendant sweeps basketball court out Exit 3
Weight Room attendant directs patrons on the track to move down the spiral staircase and out
Exit 3 (from basketball courts)
Weight Room monitor will direct people in weight room up to Exit 3. This person will also
sweep basketball courts and track, directing patrons out Exit 3 (from basketball courts).
Guest Services Attendant sweeps offices and aerobics studios out Exit 4 (front entrance) and
waits to direct emergency services.
Rally point for all members, guests and staff is located at the bike rack by Tennis Court
Point person designee will be present at Rally Location with FCC radio
13
Emergency Exits for Brodie Recreation Center
There will be three primary exits used during a situation requiring emergency evacuation of the Brodie
Recreation Center. (See Map in Appendix)
The main building entrance/exit
The side exit off of the upper basketball court
The side exit directly across from the locker rooms in the pool area
Rally location is in front of Blackwell Residence Hall
Point person designee will be present at Rally Location with FCC radio
Recreation and Physical Education employees will be our designated representatives for each exit point.
The lifeguards will sweep the pool area directing patrons to the exit opposite of the locker rooms
in the pool area.
Lifeguards will bring the radio with them to Rally Location.
If pool is closed, no one is allowed in the natatorium.
Employees should bring radio to exit points.
The guest services staff member will sweep the following:
o weight room
o multipurpose room
o racquetball courts
o first floor restrooms
o first floor basketball courts
o hallway leading to the locker rooms
o the men’s and women’s locker room
o mind and body studio
o the office suite o Staff member will direct all patrons to the main exit and inform members of Rally Location
The facility monitor on duty will sweep the:
o upper level, consisting of:
stairway leading upstairs
cardio areas
classroom
upper basketball court consisting of the track above
Staff member will direct all patrons out the building’s side exit off of the
upper basketball court.
14
Emergency Response Equipment Location by Facility
Wilson Recreational Center
First Floor Alarm (1)
Fire Extinguisher (1)
Corridor Outside of Elevator
-Exit to outside (alarm exit) – exit leads to loading area at back of Wilson (“Bat Cave”)
- Fire Extinguisher
Second Floor Alarms (3)
Fire Extinguishers (3)
Emergency Exits (3)
Stair Exits (1)
Emergency Phone (3)
AEDs (1)
Spin Class Area -Alarm (1) in Spin Room area (wall closest to stairs where curtain is)
Corridor adjacent to Spin Class -Exit to Stairs (1) (non-alarm)
-Alarm (1) near elevator and stair exit
-Fire Extinguisher (1) on wall closest to Spin Room
Combative Room, Racquetball Courts, Pool Entrance Section, TRX Section, Back Corridor
-Emergency Phone (1) on wall between Combative Room and Racquetball Courts
-AED (1) in Combative Room (door locked)…*First Aid Kit?
-Fire Extinguishers (2)
*One at Pool Entrance – left wall
*One at Back Corridor where exit is
-Emergency Exit (1) (alarm exit) at Back Corridor – Exit leads to stairs outside at back of Wilson.
-Alarm (1) in Back Corridor at Exit
Men’s Locker Room -Emergency Phone (1) on wall upon entering
-Emergency Exit (1) (alarm exit) back corner – leads to above back corridor and outside stairs
*There is no sign stating that alarm will go off for this exit
-(2) Exits from Locker Room to Pool Area
Women’s Locker Room
-Emergency Phone (1) on wall upon entering
-Emergency Exit (1) (alarm exit) back corner – leads to above back corridor near spin room and elevator
-(2) Exits from Locker Room to Pool Area
15
Third Floor
Alarms (9)
Fire Extinguishers (5)
Emergency Exits (5)
Stair Exits (3)
Emergency Phone (1) *did not include monitors desk in weight room
AEDs (1)
First Aid Kits (2)
Back Corridor closest to Climbing Wall -Emergency Exits (2) (alarm exits) – exits lead to back of Wilson
-Alarms (2) at exits
-Fire Extinguisher (1)
Climbing Wall -First Aid Kit (1) at desk
Treadmill, Elliptical, Classrooms etc. Area -Emergency Phone (1) on wall nearest classroom 20
-Fire Extinguishers (2)
*One left wall near pool entrance
*One right wall in back treadmill area where TV is located
-Alarm (1) at left exit to stairwell
-Exit to Stairs (1) at left side in back treadmill area
-Emergency Exit (1) (alarmed exit) at right side back treadmill area – exit leads to Pool Lobby Room
Lobby area prior to Weight Room, Corridor where Bathrooms are adjacent to Weight Room and Wheelchair
Ramp Corridor -AED (1) on wall close to classroom 18
-Alarms (3)
*One on pillar when walking towards Weight Room
*One at Stairs Exit (nearest wheelchair ramp)
*One at Hallway Exit (bathroom corridor) leading to spiral stairwell
-Stair Exits (2)
*One near wheelchair ramp
*One down hallway adjacent to weight room (leads up to an emergency exit in Basketball Courts)
-Fire Extinguishers (2)
*One in hallway next to lockers and coat hangers (hallway adjacent to weight room)
*One in corridor where spiral stairs are (corridor connected to hallway adjacent to weight room)
Weight Room -Emergency Exits (2) (alarm exits) – lead to grass hill at back of Wilson
-Alarms (3)
*One at Emergency Exit right
*One at Emergency Exit left
*One at Main Entrance (right wall when facing stairs)
-First Aid Kit (1) at Monitors Desk
-Phone (1) at Monitors Desk
*No AED at Monitors Desk
16
Fourth Floor Alarms (8)
Fire Extinguishers (9)
Emergency Exits (5) *did not include main exit and behind monitors desk
Stair Exits (1) *did not include spiral stairs in basketball court area
Emergency Phone (1) *did not include monitors desk at main entrance
AEDs (1)
First Aid Kits (1)
Main Entrance -Main Exit
*Can exit behind monitor’s desk (not an entrance)
-Alarm (1) near exit doors in lobby
-AED (1) at monitor’s desk
-First Aid Kit (1) at monitor’s desk
-Phone (1) at monitor’s desk
Corridor/Hallway with Offices, Quenchers, etc. -Fire Extinguishers (2)
*One near Lisa Wright’s Office
*One at back exit where Offices are (room 104)
-Emergency Exit (1) (alarm exit) near Offices (room 104) – exit leads to front of Wilson where main entrance is located
-Alarm (1) at back emergency exit near Offices (room 104)
Multipurpose Room A – 110 -Fire Extinguisher (1)
Multipurpose Room B – 125B -Fire Extinguisher (1)
Hallway leading to Basketball Courts/Middle Stairs -Emergency Phone (1) next to TV and cork boards, close to Multipurpose Room B – 125B
-Fire Extinguisher (1) on wall next to Emergency Phone
Lobby Area outside of Basketball Courts -Stairs Exit (1) near elevator
-Alarm (1) on wall next to elevator and stairs exit
Basketball Courts -Fire Extinguishers (4)
*One at main entrance
*One at back wall on right court (outside court)
*One at back wall on left court (outside court)
*One at Emergency Exits near spiral stairs
-Alarms (5)
*One at main entrance
*One at Emergency Exit right side (back of courts)
*One at Emergency Exit left side (back of courts)
* Two at Emergency Exits near spiral stairs
-Emergency Exits (4)
*Two at back of courts left and right side – lead to side of Wilson, with stairs, where IM Building is located
*Two near spiral stairs – lead to front of Wilson, lawn area closest/near Tennis Center
-Automatic Closing Fire Door at Emergency Exit near spiral stairs.
17
Fifth Floor Alarms (2)
Fire Extinguishers (3)
Emergency Exits (0)
Stair Exits (2)
Emergency Phone (0) *Emergency Intercom?
AEDs (0)
First Aid Kits (0)
Indoor Track Area -Fire Extinguishers (3)
*One outside area from Track near spiral stairs (other side of door)
*One back wall right side
*One back wall left side
-Stair Exits (2): One on each side of track
-Alarms (2)
*One at Stairs Exit near elevator
*One at Stairs Exit spiral stairs side
-Emergency Intercom (wall on elevator side)
Stair Well Connector Fire Extinguishers (4)
-Fire Extinguisher in between each floor
Taishoff Aquatics Center
Alarms (3)
Fire Extinguishers (2)
Emergency Exits (2)
First Aid Kit (2)
AED (1)
-Alarm at Swim Coach Office Door
-Alarm at Exit in Swim Coach Corridor near exit door
-Emergency Exit in same area
-Alarm at Exit Door (Emergency Exit) near entrance to Women’s Locker Room
-First Aid Kit on wall near 1st Lifeguard stand (opposite Lifeguard office)
-AED on wall near 1st Lifeguard stand (opposite Lifeguard office)
-First Aid Kit in Lifeguard Office
-Fire Extinguisher on wall next to Lifeguard Office
-Fire Extinguisher on wall at pool check-in desk
Pool Lobby & Stairwell leading down to Coach’s Office
Alarms (4)
Fire Extinguishers (1)
Exits (2)
-Alarm (2) on near each exit door
-Alarm near stairs door
-Alarm in stairwell area outside of Coach’s Office Area
-Fire Extinguisher on wall in lobby near pool entrance
18
Card Gym
Ground Level Alarms (3)
Fire Extinguishers (3)
Exits (2)
-Alarm at Exit Doors (Fencing Room Side)
-Fire Extinguisher on wall near Equipment Room
-Fire Extinguisher on wall at bottom of stairs (Track & Field Locker Room Area)
-Alarm at Exit Doors (017 Office)
-Fire Extinguisher near Mechanical Room 019 (Mike Ryan Office Side)
-Alarm at bottom of stairs (Mike Ryan Office Side; stairs that come down from basketball court level)
PLEASE READ THIS AGREEMENT CAREFULLY. IT IS A LEGAL CONTRACT AND AFFECTS
ANY RIGHTS YOU OR YOUR CHILD/WARD MAY HAVE IF HE/SHE IS INJURED OR
OTHERWISE SUFFERS DAMAGES WHILE PARTICIPATING IN Duke’s Aquatic Programs
(Activity). Be aware that by registering your child/ward (Participant) and having her/him participate in this Activity, you _______________________ and the Participant _____________________________ will be
waiving all claims for injuries the Participant might sustain arising out of his/her participation in this Activity.
In consideration of the Participant being permitted to take part in this Activity, we confirm by our signatures
below that we understand and agree to the following: 1. Assumption of Risks of Activity Participation: I/We understand that participation in the Activity is entirely voluntary and
that Duke University makes no representation about the safety or security of the location of the Activity or the modes of
travel in connection with the Activity, if any. I/We understand that risks are inherent in participating in this Activity and that
these risks could result in property damage and/or bodily injury to the Participant. I/We agree to accept and assume,
knowingly and voluntarily, all risks associated with the Activity whether present or future, known or unknown, arising from
or as a result of the Participant’s voluntary participation in the Activity. I/We have discussed the risks associated with the
Participant’s participation in the Activity as reflected by our signatures below. I/We hereby elect to participate in the
Activity.
2. Release and Waiver of Liability:
In return for Duke University permitting the Participant to register and participate in the Activity and having read
and understood this Participation Agreement, I/we hereby voluntarily agree to the following:
A. I/WE RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Duke University, its affiliates, trustees,
officers, employees or agents, (hereinafter referred to as RELEASEES) for any liability, claim, and/or cause of action
arising out of or related to any loss, damage, injury or harm of any sort, including death, that may be sustained by the
Participant, and for damage to any property belonging to him/her, that occurs as a result of traveling to or from any site
in connection with the Activity, or as a result of the Participant’s participation in the Activity. It is our intent and
agreement that the terms of this Section 2 shall bind any person asserting rights on our behalf, or otherwise asserting
claims by or through us, including my spouse, family members, heirs, assigns and personal representatives.
B. I/We further agree that this Participation Agreement, including this Section 2 shall be construed in accordance with the
laws of the state of North Carolina. Further, the release, waiver, discharge and covenant not to sue as expressed in this
Section 2 is given pursuant to the Uniform Contribution Among Tortfeasors Act, North Carolina General Statutes
Section 1B et seq. It is my/our intention not only to release any and all claims against RELEASEES, but also to relieve
RELEASEES from any liability to make contribution to other tortfeasors on account of any claims.
C. In signing this Waiver and Release, I/We acknowledge and represent that I/we have informed ourselves fully of the
contents of this Waiver and Release of liability and hold harmless agreement by reading it before we sign it, and that
I/we have reviewed it and Participant understands what it means and that I/We sign this document freely. I/We further
state that there are no health-related reasons or problems which preclude or restrict the Participant’s participation in this
Activity.
[NOTE: Participant and the Participant’s Parent/Guardian agree that this Participation Agreement may be executed in counterparts
(i.e., each required signature may appear on separate printed copies of the Participation Agreement), and that such counterpart
versions each shall be deemed an original and together shall constitute one and the same document for legal purposes.]
Participant: _______________________________________ Date: _________________________ I am the parent or guardian of the above-named Participant. I have reviewed this Participation Agreement and the description of the
Program, have discussed it with the Participant and concur with the Participant’s participation in the Program under the terms of this
Participation Agreement. Parent or Guardian: ________________________________ Date: _________________________
*** Specific location within building/area (court #, field #, machine #/description, etc.) ______________________________________________________
EAST CAMPUS ☐ Brodie Center ☐ Brodie Pool ☐ Fields ☐ Tennis Courts ☐ Trail ☐ Other _________________________
*** Specific location within building/area (court #, field #, machine #/description, etc.) ______________________________________________________
CENTRAL CAMPUS ☐Basketball Courts ☐Fields ☐Pool ☐Other ___________________________________________
*** Specific location within building/area (court #, field #, machine #/description, etc.) _______________________________________________________
OTHER _______________________________________________
*** Specific location within building/area (court #, field #, machine #/description, etc.) _____________________________________________________ PROGRAM area of participation: Check all that apply