Informed Consent for Minors and their Parent 2024

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This is an informed consent form for minors, which identifies risks of participating in a Weber State University ("WSU") activity or program, and a consent form for parents/guardians.

WSU PREP June 3 - July 18

Downloadable version of consent form: https://docs.google.com/document/d/1MKXrYHLGIe2K7sYdT7JZt9o8s35t2_X0bEdhsizjlOo/edit?usp=sharing

Parent or Guardian, read and sign this section:
I have been informed of the nature of the Activity, listed above, which my minor child wishes to participate in. I recognize that the Activity may involve moderate to strenuous physical activity and may cause physical and ' or emotional distress to participants. I state that my minor child is free from any known heart, respiratory or other health problems that could prevent her or him from safely participating in the Activity. I consent to the participation of my minor child in Activity.

Consent is expressly given, in the event of injury, for any emergency aid, anesthesia, and/or operation, if in the opinion of the attending physician, such treatment is necessary.

In the box below, provide Parent/Guardian's name:

Provide today's date as date signed:

YYYY

Photo Release
I authorize and release WSU the use of my child's image in any photograph or video recording for any purpose of WSU.

In the box below, provide Parent/Guardian's name:

Student Email
Participation in 2024 WSU PREP requires all students to be added to Canvas courses via email. These emails will be accessible to PAs, teachers, and other students. Students may communicate via email/chats, but these communications will not be monitored by WSU PREP.
This is a required item. Students cannot be added to their classes without their email listed.
Please provide the student's email in the box below:

Participating minor child, read and sign this section:

I desire to participate in the Activity described above. I agree to familiarize myself with the Activity and what is required, rules of conduct and safety equipment. I agree to follow proper operating procedures including safety procedures as outlined by the Activity leader, plus any directions given by WSU personnel. I agree to follow the rules of conduct and use the provided safety equipment.

In the box below, provide Participant's name:

Provide today's date as date signed:

YYYY

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