Southern Miss Student Combine

country market

powerade

Southern Miss Students, show us what you've got in the inaugural Southern Miss Student Combine, presented by Corner Market and PowerAde! You'll have the chance to test your skills in a 40-yard dash, shuttle run, broad and vertical jump, and more, all for a chance to win prizes from Corner Market and PowerAde. To join us, register here (waiver required) and meet us at the north end of The Rock (M.M. Roberts Stadium) on Fri., Apr. 21 beginning at 3:15 p.m. (event begins at 4:00 p.m.). T-shirts will be given to those to pre-register, and the event is free to Southern Miss Students (student ID will be required to be shown on the day of the event).


University of Southern Mississippi Athletics
Release and Assumption of Risk

The University of Southern Mississippi is hosting a Student Combine, complete with NFL Combine style drills, as part of the celebratory events leading up to the annual Black and Gold Spring Game. This activity is offered by the University to students at the University of Southern Mississippi who are willing to assume the risks associated with that activity. IF YOU DO NOT CLEARLY UNDERSTAND THE RISKS OF THE STUDENT COMBINE OR ARE NOT WILLING TO ASSUME THOSE RISKS, YOU SHOULD STOP HERE AND ABANDON THE ACTIVITY. PROCEED ONLY IF YOU ARE CONFIDENT THAT YOU DO UNDERSTAND THE RISKS AND ARE WILLING AND ABLE TO ASSUME THOSE RISKS.

PARTICIPANT (print name here)

For and in consideration of the permission to participate in the Student Combine ("the activity"), I do hereby release and agree to defend, indemnify and hold forever harmless, the University of Southern Mississippi, its Trustees, Officers, Agents, Employees (including students employed by the University, whether part-time or full-time), and all members of the Athletic Department from any responsibility, liability, obligation, claims, demands, injury or damage to person (including death or disability) or property of myself or others arising from, growing out of or resulting from my participation in this activity, whether caused by my own negligence or the negligence of others

I realize and agree that participating in the Student Combine has inherent risks, some of which may include (but are not limited to) the following:

1. All manner of injury and/or death resulting from participation in the events included in the Student Combine;
2. Cuts, abrasions or other injuries resulting from contact with the playing surface, related equipment, stadium equipment, or other participants;
3. My own negligent acts or the negligence of others who are involved with the Student Combine activity, whether employed by the University or not;
4. Failure or insufficiency of any of the equipment used in the Student Combine; and
5. Failure to disclose any health or medical issues that would disqualify the student from participating in the Student Combine.

I understand that participation in this activity is purely voluntary and is not part of the academic curriculum of the University of Southern Mississippi; and, that this activity involves substantial risk of bodily injury and/or death, property damage and other damages associated with participation in such activity. With full knowledge of such risk, I hereby agree to assume such risks normally associated with participation in said activity, and relieve the University of any and all liability for such losses, injuries or death. I expressly understand and agree to be solely responsible for any costs arising out of any bodily injury or property damage sustained through participation in this activity. I understand that the University will not be responsible for any medical bills I incur as a result of participation in this activity.

I agree that the purpose and intent of this agreement is that it shall be an enforceable release of liability and indemnity as broad and inclusive as is permitted by Mississippi law. I agree that if any portion of this agreement is found to be invalid or unenforceable, then the remainder will continue in full force and effect, and that any invalid provision will be modified or partially enforced to the maximum extent permitted by law to carry out the purpose of the agreement.

FOR MARRIED OR STUDENTS UNDER 18 ONLY*

I understand that, as a married and/or student under 18, the signature of my spouse, parent or guardian is required in the space indicated below and that such signature signifies acceptance by said spouse, parent or guardian that the terms and conditions herein shall be binding upon them and shall constitute a release by them in the same manner and with the same force and efforts as above set forth in regard in participating in the said activity.

YOU MUST READ THIS ENTIRE DOCUMENT CAREFULLY BEFORE SIGNING. THIS RELEASES THE UNIVERSITY OF SOUTHERN MISSISSIPPI FROM ANY LIABILITY RESULTING FROM MY PARTICIPATION IN THE ABOVE DESCRIBED ACTIVITY. BY SIGNING THIS DOCUMENT, I CERTIFY THAT NO OTHER REPRESENTATIONS HAVE BEEN MADE TO ME THAT CHANGE, ALTER, OR MODIFY ANYTHING WITHIN THIS WRITTEN AGREEMENT. I UNDERSTAND THAT THIS ACTIVITY CAN BE DANGEROUS. I CERTIFY THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT, AND AGREE TO BE BOUND BY ITS TERMS.

USM ID#:       Date of Birth:

Campus/Local Address:

Local Phone Number:

E-mail Address:

Parent's Name and Address:

Parent's Phone Number:

Emergency Contact Person:       Phone:

Address:

Initial here:

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