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Risk Waiver and Informed Consent Form

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UTAH VALLEY UNIVERSITY
ACTIVITY PARTICIPATION AGREEMENT

PARTICIPANT:

Name: (“Participant”)

Address:

Phone Number:

LOCATION(s):

DATE(s):

EMERGENCY CONTACT INFORMATION:

Name:

Phone Number:

DESCRIPTION OF ACTIVITY:

TERMS

This Activity Participation Agreement (the “Agreement”) is entered into as of the last signature date below, by and between Utah Valley University, a body politic and corporate of the State of Utah (“UVU”), and Participant.

Participant acknowledges that this Agreement contains, among other provisions, the following contractual terms: an assumption of risk, a covenant not to sue, a release of the Participant’s claims, and indemnification obligations. Participant represents that Participant is 18 years of age or older and is fully competent and authorized to sign this Agreement. In consideration for UVU permitting Participant to engage in the Activity, Participant, and for its respective heirs, personal representatives, and assigns, agrees as follows:

Assumption of Risk. Participant represents that Participant is qualified, in good health, and in proper physical condition to participate in the Activity. Participant acknowledges and understands that the Activity may include but is not limited to the following: physical activities (e.g., running, jumping, climbing); physical exertion such as lifting or moving heavy objects; spending extended periods of time outdoors being exposed to the elements (sun, wind, rain); travel to and from the Activity; and consumption of food and/or beverage. Participant acknowledges and understands that Participant may be exposed to certain risks that are inherent in participation in the Activity. These risks may include but are not limited to such things as incidents related to the above-mentioned activities, including sprains, broken bones, cuts, bruises, entrapment, temporary or permanent disability, illness, personal injury, and/or death; adverse weather conditions; exposure to theft and other criminal activity; allergic reactions to food and drink items; other physical, mental, and emotional injury; other risks and dangers, whether known or unknown nor reasonably foreseeable. Participant knowingly and voluntarily, accepts, and assumes responsibility for each of these risks and dangers, and all other risks and dangers that could arise out of, or occur during, Participant’s engagement in the Activity.

Covenant Not to Sue: Participant agrees that it will not commence any legal action or lawsuit or otherwise assert any legal claim against UVU and its officers, directors, employees, and agents seeking relief for any claim, whether or not such claim is released or waived under this Agreement.

Indemnification: Participant agrees to indemnify and hold UVU and its trustees, officers, directors, employees, and agents harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, arising out of Participant’s involvement in the Activity and to reimburse UVU for any such expenses incurred.

Release of Claims: Participant releases and fully discharges UVU, including its trustees, officers, agents, and employees, from any and all claims or causes of action that may be brought by Participant, or by any other person (including but not limited to Participant’s estate, family, successors, heirs, representatives, administrators, and/or assigns), including all liability for damage to personal property, personal injury or loss arising out of or related to Participant’s engagement in the Activity to the fullest extent permitted by law.

Severability/Governing Law: Participant agrees that this Agreement is intended to be as broad and inclusive as is permitted by the law of the State of Utah and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. The Agreement shall be governed by the laws of the State of Utah, without regard to conflicts of laws principles. Venue for any lawsuits, claims, or other proceedings between the Parties relating to or arising under the Agreement shall be exclusively in the State of Utah.

Health Insurance and Consent to Medical Treatment: Should Participant require emergency medical treatment as a result of accident or illness arising during the Activity, Participant consents to such treatment. Participant acknowledges that UVU will not provide health and accident insurance for Participant, and Participant agrees to be financially responsible for any medical bills incurred as a result of emergency medical treatment.

Likeness Release: Participant authorizes UVU, acting through its agents, employees, or representatives, to take photograph, video, and/or audio recordings of Participant, including Participant’s name, image, likeness, performance, and/or voice (“Recordings”). Participant grants UVU an unlimited right to reproduce, use, exhibit, display, perform, broadcast, create derivative works from, and distribute the Recordings in any manner or media now existing or hereafter developed, in perpetuity, throughout the world. Participant agrees that the Recordings may be used by UVU, including its assigns and transferees, for any purpose including but not limited to marketing, advertising, publicity, or other promotional purposes. Participant agrees that UVU will have final editorial authority over the use of the Recordings, and Participant waives any right to inspect or approve of any future use of the Recordings. Participant acknowledges that Participant is not expecting to receive compensation for participating in the Recordings or for any future use of the Recordings. Participant releases and fully discharges UVU, and its employees, agents, and representatives, from any claim, damages, or liability arising from or related to Participant’s inclusion in the Recordings or UVU’s future use of the Recordings.

Acknowledgment: I understand the legal consequences of signing this document, including (a) releasing UVU and its trustees, officers, directors, employees, and agents from all liability on my and the Participant’s behalf, (b) promising not to sue, (c) and assuming all risks of participation in this Activity, including travel to, from, and during the Activity. I understand that I am responsible for the obligations and acts of Participant as described in this document. I agree to be bound by the terms of this document. I have read this two-page document, and I am signing it freely and voluntarily.

Signature of Participant

Date:

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What a Risk Waiver and Informed Consent Form Is

A Risk Waiver and Informed Consent Form documents that an individual understands and accepts potential risks associated with an activity, treatment, or service and, where applicable, releases the provider from specified liabilities. It combines factual disclosures about probable hazards, acknowledgement of voluntary participation, and a signature block that records consent. In healthcare and higher-risk activities this form clarifies procedures, alternatives, expected outcomes, and any known complications while preserving a record that can support clinical or operational decisions.

Why this Form Matters for Liability and Clarity

A clear waiver and informed consent form reduces ambiguity about risks, documents participant understanding, and supports compliance with professional and regulatory obligations. It helps organizations manage expectations and preserves evidence of disclosure and agreement.

Why this Form Matters for Liability and Clarity

Who Typically Uses the Risk Waiver and Informed Consent Form

Organizations and professionals who run activities, provide medical or therapeutic care, or deliver experiential services commonly use this form to document consent and risk acknowledgement.

  • Healthcare providers and clinics — used for procedures, minor treatments, experimental therapies, and telehealth consents.
  • Recreation and sports operators — used for classes, adventure activities, and events with physical risk.
  • Schools and youth programs — used for field trips, athletics, and activity permissions for minors.

Use the form whenever a participant must understand material risks before proceeding, or when proof of informed decision-making could affect liability or regulatory compliance.

Essential Elements to Include in a Professional Consent and Waiver

A professional Risk Waiver and Informed Consent Form balances plain-language risk disclosure with legally relevant provisions; include clear, specific sections so signers know what they are authorizing and what rights they are waiving.

Risk Disclosure

Describe specific, material risks in plain language, including likelihood and potential consequences, so the signer can make an informed decision and the disclosure can be evaluated later if needed.

Scope of Consent

Specify the exact procedures, activities, or data uses covered by the consent, including start and end dates, any limitations, and whether future related activities are included under the same authorization.

Assumption of Risk

State the participant’s voluntary acceptance of identified risks and any responsibilities assumed during participation, clarifying that assumption does not remove duties of care by the provider.

Release Clause

If a release of liability is included, define the parties covered, the specific claims being waived, and any restrictions consistent with applicable state law to avoid overbroad or unenforceable terms.

Alternatives and Questions

Explain reasonable alternatives, expected benefits, and where signers can direct questions; include a statement that the signer had opportunity to ask questions and received answers.

Signature Details

Include printed name, signature, date, signer relationship (self, guardian, power of attorney), and witness/notary fields where state law or institutional policy requires validation.

Required Data Elements

Signer Name: Full legal name
Date of Birth: MM/DD/YYYY
Activity Description: Specific program or procedure
Signature: Handwritten or electronic
Relationship: Self, guardian, agent
Witness/Notary: If required

How to Complete the Form, Step by Step

Follow a simple sequence when presenting and collecting signed waivers and consents to ensure clarity, capacity assessment, and a reliable record of the transaction.

  • 01
    Provide Disclosure: Give the signer full written and verbal explanation of risks and alternatives.
  • 02
    Confirm Understanding: Ask the signer to summarize key points and answer their questions.
  • 03
    Record Details: Complete identity fields, dates, and activity descriptions accurately.
  • 04
    Obtain Signature: Collect the signature and any required witness or notary validation.

Customizing and Delivering the Form Online

Set up a predictable digital workflow so recipients receive the right fields in order and signers get a copy automatically upon completion.

Field Configuration
Signature Field Require initials and signature for high-risk clauses
Conditional Fields Show guardian fields if signer is minor
Authentication Use email + SMS code for identity verification
Delivery Auto-send signed PDF to all parties

Where to Send or Store Completed Forms

Define official recipients and retention location to ensure access, auditability, and compliance with privacy rules.

  • Primary Record: Store in protected EHR or secure document management
  • Participant Copy: Provide signed copy to the signer promptly
  • Third Parties: Send to insurers or legal counsel as authorized
  • Audit Trail: Retain signing evidence and access logs

Digital Signing and Technical Requirements

When using electronic signature platforms, select settings that protect identity, preserve audit trails, and meet regulatory controls such as HIPAA or 21 CFR Part 11 where applicable.

  • Authentication: Email, SMS, or stronger multifactor
  • Encryption: TLS in transit; AES-256 at rest
  • Integrations: EHR and cloud storage connectors

Timing and Processing Expectations

Set clear timing rules for delivery, signature, and record distribution so participants and staff understand deadlines and turnaround times.

Before Activity:

Signed and returned prior to participation

Provider Review:

Allow 24–72 hours for clinician questions

Minor Consent Deadlines:

Guardian signature required before activity

Emergency Exceptions:

Document rationale for delayed consent

Record Delivery:

Send signed copy within 3 business days

Common Preparation Mistakes to Avoid

  • Using overly broad release language that may be unenforceable under state consumer protection or negligence law.
  • Failing to tailor risk descriptions to the specific procedure or activity, leaving signers uninformed about material hazards.
  • Collecting signatures without confirming capacity, consent ability, or the signer’s legal authority to sign for another.
  • Storing signed forms in insecure locations or without an auditable trail that shows who signed and when.

Consequences of an Incorrect or Missing Form

Unenforceability: Form may be invalid
Civil Liability: Increased exposure to negligence claims
Regulatory Fines: HIPAA enforcement risk
Insurance Denial: Coverage disputes possible
Operational Delay: Services postponed or refused
Reputational Harm: Loss of trust by participants

Comparing eSignature Options for Executing Consents and Waivers

Platform selection affects authentication, HIPAA support, bulk distribution, and overall cost; compare core features and compliance before integrating a solution.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day trial, no CC Varies by offer Varies by offer Varies by offer Varies by offer
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Real-World Examples of Use

Representative scenarios show how organizations adapt the form to practical workflows and compliance needs.

Clinic Consent Example

A community clinic provided procedure details and alternatives in plain language to low-literacy patients

  • Clinician reviewed key risks verbally
  • The signed consent, stored in the EHR, supported quality review and billing audits.

Outdoor Program Example

An outdoor education provider required risk acknowledgement for high-ropes courses with specific hazard descriptions

  • Parents initialed emergency transport consent
  • Electronic copies were retained with timestamps and IP-based audit trails for incident review.

Practical Tips for Clear, Enforceable Waivers and Consents

Adopt consistent drafting and collection practices to reduce disputes and simplify audits.

Use Plain Language
Write disclosures in straightforward terms, avoiding legalese that participants may not understand.
Tailor to Activity
Describe real, activity-specific risks rather than relying on generic boilerplate.
Confirm Capacity
Assess signers’ ability to consent; document any limitations or use of a legally authorized representative.
Preserve Evidence
Keep signed copies with an audit trail that records timestamps, signer contact, and authentication method.

FAQs and Troubleshooting for Common Issues

Answers to frequent questions about validity, signatures, and handling special circumstances when using Risk Waiver and Informed Consent Forms.


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