Alaska Pacific University
Discover Active Learning
I, the undersigned, in full recognition and appreciation of the dangers and hazards inherent to the above
mentioned programs or class, do hereby voluntarily agree to assume all associated risks and
responsibilities to which I may be exposed during transportation to and from all activities or classes and
during my participation in the activity or class. In addition, I intend to be financially responsible for any
property damage / loss or injuries that may occur as a result of my negligence or failure to follow
instructions. I have been provided verbal and /or written information that describes the activities and their
inherent dangers, hazards, and possibilities of injury or damage (see third paragraph). In addition, I have
been or will be provided with training to safely participate in each activity or segment of the activity.
Further, I do, for myself, my heirs, successors, assigns, and personal representative(s), hereby agree to
release Alaska Pacific University, it’s Board of Trustees, officers, agents, and employees from all liability,
loss, damage and expense, including reasonable attorney fees, which may arise on account of damage to
property or personal injury, death or emotional distress resulting from my transportation to and from or my
participation in all activities or classes, provided the damage, injury, death or emotional distress does not
result from the gross negligence or intentional misconduct of Alaska Pacific University, its Board of
Trustees, their officers, agents, or employees.
I enter into the exercise and fitness program offered at Alaska Pacific University voluntarily. I am aware that there are potential risks involved in traveling through the wilderness in Alaska.
Some risk include, but are not limited to, encountering severe weather, avalanche, bear, moose, or
other wild animals; falling a long distance in steep terrain; slipping on ice; pulled, sore and / or
strained muscles; shin splints; and other various exercise related injuries; I also understand that
when traveling in a University vehicle or any personal vehicle there is potential risk of being
involved in a traffic accident. These hazards and risks may result in a head or spinal injury,
paralysis, broken bones, separated joints, severe lacerations, frostbite or death. All participants
are advised to properly dress for extreme weather conditions and be prepared for backcountry
survival in the event of an emergency.
I am in good health and have my physicians’ approval to exercise. I will inform the instructor or coach of
any changes in my health status. I hereby authorize APU to request on my behalf, should I be injured or
require emergency treatment, medical assistance including ambulance, and agree to be responsible for
all costs thereof. I have proof of health insurance that will cover any injury that I might sustain during this
4101 University Drive
Anchorage, Alaska 99508