FIUTS Acknowledgement of Risk

In offering this program, FIUTS makes effort to inform recipients of the health risks involved in the activity and assist them in developing plans to mitigate those risks. However, FIUTS cannot assume responsibility for damage to or loss of property, personal illness, injury, or death of a student, or emergency response related to any of these activities.

We require that each participant read the Acknowledgment of Risk linked below and agree to accept the risks associated with the activity.

FIUTS Acknowledgement of Risk

Name

First Name

Last Name

Email

Date

MM

DD

YYYY

Activity

Please provide the name and date of the activity you are partaking in.

I have read and understand the contents detailed in FIUTS Acknowledge of Risks

Yes

I understand that I am providing my electronic signature in agreement to the FIUTS Acknowledgement of Risk by submitting this form

YES

FIUTS Acknowledgement of Risk

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Action

land Acknowledgement