UNIVERSITY OF WISCONSIN – EAU CLAIRE
SPORT CLUBS
PARENTS/GUARDIANS CONSENT AND RELEASE FORM
I,_____________________________________,
being the parent or duly constituted
guardian of ____________________________, a minor, age__________, and a student
at the University of Wisconsin – Eau Claire and a member of the ________________
_______________________, an approved University Sport Club, do hereby consent to
the participation of _________________
_______________________ in the activities of said Sport Club. I hereby release the
Trustees of the University of Wisconsin – Eau Claire and all or any officers or agents of
said University, said Sport Club, for personal injury sustained by the student or for any
property damage caused by him/her during or because of his/her participation in the
activities of the Sport Club.
Name____________________________________
Signature_______________________________
Address_________________________________
________________________________________
Date____________________________________
Note: To be turned in at the Sport Clubs Coordinator’s Office
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