INTERCOLLEGIATE ATHLETIC PROGRAM: (Cheer Team)

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

I, ____________________________ [print name] (“Participant”), hereby acknowledge that I have voluntarily elected to participate in
the Intercollegiate Athletic Program (“Program”), including tryouts, to be held in and around the University of Evansville campus, the
City of Evansville, Vanderburgh County, locations as determined by the _2013-14___________(insert fiscal year) schedule for this
sport and other locations as determined necessary for the _2013-14_______ (insert fiscal year) season. In consideration for being
permitted by the University of Evansville (UE) to participate in the Program, I hereby acknowledge and agree to the following:

ELECTIVE PARTICIPATION: I acknowledge that my participation is elective and voluntary.

RULES AND REQUIREMENTS: I agree to conduct myself in accordance with UE policies and procedures, including the UE Student
Athlete Handbook, the UE Student Handbook and all applicable NCAA and MVC requirements. I further agree to abide by all the rules
and requirements of the Program. I acknowledge that UE has the right to terminate my participation in the Program if it is determined
that my conduct is detrimental to the best interests of the group, my conduct violates any rule of the Program, or for any other reason in
UE’s discretion, except for those occurrences due to UE’s negligence or intentional acts.

INFORMED CONSENT: I have been informed of and I understand the various aspects of the Program. I understand that as a
participant in the Program, I will be engaged in activities that may include, but not limited to, practicing, training, observing, traveling to
and from, and competing in Program events, during which I could sustain serious personal injuries, illness, property damage, or even
death as a consequence of not only UE’s actions or inactions, but also the actions, inactions, negligence or fault of others, and that
there may be other risks not known to me or not reasonably foreseeable at this time. I further understand and agree that any injury,
illness, property damage, disability, or death that I may sustain by any means is my sole responsibility, except for those occurrences
due to UE’s negligence or intentional acts.

RELEASE AND WAIVER OF LIABILITY & INDEMNIFICATION: I, on behalf of myself, my personal representatives, heirs, executors,
administrators, agents, and assigns agree to HOLD HARMLESS, DEFEND, INDEMNIFY, RELEASE, WAIVE, DISCHARGE, AND
COVENANT NOT TO SUE UE, its Board of Trustees, directors, officers, employees, coaches, trainers, agents, volunteers and any
students (hereinafter referred to as “Releasees”) for any and all liability, including any and all claims, demands, causes of action (known
or unknown), suits, or judgments of any and every kind (including attorneys’ fees), arising from any injury, property damage or death
that I may suffer while playing, practicing or in any other way involved in my participation in the Program, REGARDLESS OF
WHETHER THE INJURY, ILLNESS, DISABILITY, DAMAGE OR DEATH IS CAUSED BY THE RELEASEES, UNLESS THE INJURY,
ILLNESS, DISABILITY, DAMAGE OR DEATH IS CAUSED BY THE RELEASEES’ NEGLIGENCE OR INTENTIONAL ACTS, AND
REGARDLESS OF WHETHER THE INJURY, ILLNESS, DISABILITY, DAMAGE OR DEATH OCCURS WHILE IN, ON, UPON, OR IN
TRANSIT TO OR FROM THE PREMISES WHERE THE ACTIVITY, OR ANY ADJUNCT TO THE ACTIVITY, OCCURS OR IS BEING
CONDUCTED. I further agree that the Releasees are not in any way responsible for any injury, illness, disability, damage or death that I
sustain as a result of my own negligent acts.

ASSUMPTION OF RISK: I understand that there are potential dangers incidental to my participation in Program activities, including but
not limited to, practicing, training, observing, traveling to and from, and competing in Program events. I understand that there are
potential dangers which may expose me to the risk of personal injuries, property damage, or even death. I am aware that the Program
can involve vigorous activity involving severe cardio-vascular stress and/or violent physical contact. I understand that Intercollegiate
Athletic activities involve certain risks, including but not limited to, death, serious neck and spinal injuries, resulting in complete or partial
paralysis, brain damages, and serious injury to virtually all bones, joints, muscles, and internal organs, and that protective equipment
may be inadequate to prevent serious injury. I further understand that Intercollegiate Athletics involve a particularly high risk of knee,
head, and neck injury. In addition, I understand that participation in the Program involves activities incidental thereto, including, but not
limited to, travel to and from the site of the Program, participation sites that may be remote from available medical assistance, and the
possible reckless conduct of other participants. Furthermore, I understand that potential risks may arise due the following: travel to and
from _tryouts, stunting, tumbling, and any other skill specified by the coach__(SPECIFY) via private vehicle, common carrier, and/or
UE owned vehicle, weather conditions, facility conditions, equipment conditions, negligent first aid operations or procedures of
Releasees, and other risks that are unknown at this time. I KNOWINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS, BOTH
KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE ACTS IF THE RELEASEES, UNLESS THEY ARISE FROM THE
RELEASEES’ INTENTIONAL OR NEGLIGENT ACTS, and assume full responsibility for my participation in the Program.

PERSONAL MEDICAL INSURANCE: I agree to purchase and maintain during the term of the Program personal medical insurance. I
further acknowledge that I am responsible for the cost of any and all medical and health services I may require not directly related to my
participation in the Program.

CERTIFICATION OF FITNESS TO PARTICIPATE: I attest that I am physically and mentally fit to participate in Intercollegiate Athletics
and that I do not have any medical record of history that could be aggravated by my participation in my particular sport. Further I agree
to abide by UE’s requirements, rules and decisions for physicals and medical exams for student athletes.
MEDICAL CONSENT: I understand and agree that Releasees may not have medical personnel available at the location of the
Program. In the event of any medical emergency, I (initial one) do____ do not____ authorize and consent to any x-ray examination,
anesthetic, medical, dental or surgical diagnosis or treatment and hospital care that UE personnel deem necessary for my safety and
protection. I understand and agree that Releasees assume no responsibility for any injury or damage which might arise out of or in
connection with such authorized emergency medical treatment.

CHOICE OF LAW: I hereby agree that this Agreement shall be construed in accordance with the laws of the State of Indiana.

SEVERABILITY: If any term or provision of this Agreement shall be held illegal, unenforceable, or in conflict with any law governing
this Agreement the validity of the remaining portions shall not be affected thereby.

I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS. I AM AWARE THAT THIS AGREEMENT INCLUDES
A RELEASE AND WAIVER OF LIABILITY, AN ASSUMPTION OF RISK, AND AN AGREEMENT TO INDEMNIFY THE RELEASEES.
I UNDERSTAND I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS AGREEMENT, AND SIGN IT FREELY AND
VOLUNTARILY WITHOUT ANY INDUCEMENT. BY MY SIGNATURE I REPRESENT THAT I AM AT LEAST EIGHTEEN YEARS OF
AGE OR, IF NOT, THAT I HAVE SECURED BELOW THE SIGNATURE OF MY PARENT OR GUARDIAN AS WELL AS MY OWN.

Signature of Participant Date

__________________________________________________ Home#:________________ Work#:_________________

Name of Emergency Contact (please print)
Cell#: _________________________

Signature of Parent/Guardian for Participants under eighteen (18) years of age:

I certify that I have custody of Participant or am the legal guardian of participant by court order. I HAVE READ THIS AGREEMENT
AND FULLY UNDERSTAND ITS TERMS. I AM AWARE THAT THIS AGREEMENT INCLUDES A RELEASE AND WAIVER OF
LIABILITY, AN ASSUMPTION OF RISK, AND AN AGREEMENT TO INDEMNIFY THE RELEASEES. I join with participant in
granting a release to Releasees as set forth in detail above.

Signature of Parent or Guardian Date

Rev. Sep. 2007