{"id":26061,"date":"2022-06-10T09:22:13","date_gmt":"2022-06-10T13:22:13","guid":{"rendered":"https:\/\/web.uri.edu\/campusrec\/?p=26061"},"modified":"2022-06-10T09:23:17","modified_gmt":"2022-06-10T13:23:17","slug":"adult-participant-information-medical-consent","status":"publish","type":"post","link":"https:\/\/web.uri.edu\/campusrec\/adult-participant-information-medical-consent\/","title":{"rendered":"Adult Participant Information\/Medical Consent"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_45' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Participant Information \/ Medical Consent & Release - Adult<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_45'  action='\/campusrec\/wp-json\/wp\/v2\/posts\/26061' data-formid='45' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_45' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_45_14\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Participant Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_45_14'>\n                            \n                            <span id='input_45_14_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_14.3' id='input_45_14_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_45_14_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_45_14_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_14.6' id='input_45_14_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_45_14_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_45_2\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_2'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_45_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_45_72\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_72'>Program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_72' id='input_45_72' class='medium gfield_select'  aria-describedby=\"gfield_description_45_72\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Sailing' >Sailing<\/option><option value='Fitness' >Fitness<\/option><option value='Aquatics' >Aquatics<\/option><option value='' ><\/option><\/select><\/div><div class='gfield_description' id='gfield_description_45_72'>Please choose the program you are submitting this form to.<\/div><\/li><li id=\"field_45_4\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_4'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_45_4' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_45_5\" class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_5'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_5' id='input_45_5' type='number' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_45_6\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_6'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_45_6' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_45_10\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_10'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_45_10' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Male' >Male<\/option><option value='Female' >Female<\/option><\/select><\/div><\/li><li id=\"field_45_16\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_45_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_45_16_1_container' >\n                                        <input type='text' name='input_16.1' id='input_45_16_1' value=''    aria-required='true'    \/>\n                                        <label for='input_45_16_1' id='input_45_16_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_45_16_2_container' >\n                                        <input type='text' name='input_16.2' id='input_45_16_2' value=''     aria-required='false'   \/>\n                                        <label for='input_45_16_2' id='input_45_16_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_45_16_3_container' >\n                                    <input type='text' name='input_16.3' id='input_45_16_3' value=''    aria-required='true'    \/>\n                                    <label for='input_45_16_3' id='input_45_16_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_45_16_4_container' >\n                                        <input type='text' name='input_16.4' id='input_45_16_4' value=''      aria-required='true'    \/>\n                                        <label for='input_45_16_4' id='input_45_16_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_45_16_5_container' >\n                                    <input type='text' name='input_16.5' id='input_45_16_5' value=''    aria-required='true'    \/>\n                                    <label for='input_45_16_5' id='input_45_16_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_45_16_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_45_21\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Medical Insurance Information<\/h2><\/li><li id=\"field_45_18\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_18'>Medical Insurance Company<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_45_18' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_45_19\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_19'>Policy Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_45_19' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_45_20\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_20'>Name of Primary Policy Holder<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_45_20' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_45_23\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Emergency Contacts<\/h2><\/li><li id=\"field_45_24\" class=\"gfield gfield--type-list gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Emergency Contacts<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_24_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_24_col_2' class='gfield_list_col_even' \/><col id='gfield_list_24_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_24_col_4' class='gfield_list_col_even' \/><col id='gfield_list_24_col_5' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Name<\/th><th scope=\"col\">Relationship<\/th><th scope=\"col\">Phone<\/th><th scope=\"col\">Cell<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_24_cell1' data-label='Name'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_45_24\" aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_24[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_24_cell2' data-label='Relationship'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_45_24\" aria-label='Relationship, Row 1' data-aria-label-template='Relationship, Row {0}' type='text' name='input_24[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_24_cell3' data-label='Phone'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_45_24\" aria-label='Phone, Row 1' data-aria-label-template='Phone, Row {0}' type='text' name='input_24[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_24_cell4' data-label='Cell'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_45_24\" aria-label='Cell, Row 1' data-aria-label-template='Cell, Row {0}' type='text' name='input_24[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><div class='gfield_description' id='gfield_description_45_24'>Please list anyone you would like the URI Campus Recreation staff to contact in the event of an emergency situation.<\/div><\/li><li id=\"field_45_83\" class=\"gfield gfield--type-list gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_83_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_83_col_2' class='gfield_list_col_even' \/><col id='gfield_list_83_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_83_col_4' class='gfield_list_col_even' \/><col id='gfield_list_83_col_5' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Name<\/th><th scope=\"col\">Relationship<\/th><th scope=\"col\">Phone<\/th><th scope=\"col\">Cell<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_83_cell1' data-label='Name'><input aria-invalid='false'   aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_83[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_83_cell2' data-label='Relationship'><input aria-invalid='false'   aria-label='Relationship, Row 1' data-aria-label-template='Relationship, Row {0}' type='text' name='input_83[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_83_cell3' data-label='Phone'><input aria-invalid='false'   aria-label='Phone, Row 1' data-aria-label-template='Phone, Row {0}' type='text' name='input_83[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_83_cell4' data-label='Cell'><input aria-invalid='false'   aria-label='Cell, Row 1' data-aria-label-template='Cell, Row {0}' type='text' name='input_83[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_45_30\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_45_31\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Participant&#039;s Health History<\/h2><\/li><li id=\"field_45_32\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Do you have any of the following?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_45_32'><li class='gchoice gchoice_45_32_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.1' type='checkbox'  value='Seizures'  id='choice_45_32_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_1' id='label_45_32_1' class='gform-field-label gform-field-label--type-inline'>Seizures<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.2' type='checkbox'  value='Heart Defect or Disease'  id='choice_45_32_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_2' id='label_45_32_2' class='gform-field-label gform-field-label--type-inline'>Heart Defect or Disease<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.3' type='checkbox'  value='Diabetes'  id='choice_45_32_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_3' id='label_45_32_3' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.4' type='checkbox'  value='Bleeding \/ Clotting Disorder'  id='choice_45_32_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_4' id='label_45_32_4' class='gform-field-label gform-field-label--type-inline'>Bleeding \/ Clotting Disorder<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.5' type='checkbox'  value='Asthma or Breathing Conditions'  id='choice_45_32_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_5' id='label_45_32_5' class='gform-field-label gform-field-label--type-inline'>Asthma or Breathing Conditions<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.6' type='checkbox'  value='Muscle, Bone, or Joint Problems'  id='choice_45_32_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_6' id='label_45_32_6' class='gform-field-label gform-field-label--type-inline'>Muscle, Bone, or Joint Problems<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.7' type='checkbox'  value='Previous Injury Still Affecting'  id='choice_45_32_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_7' id='label_45_32_7' class='gform-field-label gform-field-label--type-inline'>Previous Injury Still Affecting<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.8' type='checkbox'  value='Ever been Knocked Unconscious'  id='choice_45_32_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_8' id='label_45_32_8' class='gform-field-label gform-field-label--type-inline'>Ever been Knocked Unconscious<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.9' type='checkbox'  value='Frequent Ear Infections or have Ear Tubes'  id='choice_45_32_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_9' id='label_45_32_9' class='gform-field-label gform-field-label--type-inline'>Frequent Ear Infections or have Ear Tubes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.11' type='checkbox'  value='Wear glasses or Contacts'  id='choice_45_32_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_11' id='label_45_32_11' class='gform-field-label gform-field-label--type-inline'>Wear glasses or Contacts<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.12' type='checkbox'  value='Orthodontic Appliance being brought to Lesson'  id='choice_45_32_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_12' id='label_45_32_12' class='gform-field-label gform-field-label--type-inline'>Orthodontic Appliance being brought to Lesson<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.13' type='checkbox'  value='Physical Limitations'  id='choice_45_32_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_13' id='label_45_32_13' class='gform-field-label gform-field-label--type-inline'>Physical Limitations<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.14' type='checkbox'  value='Special Fears or Conditions'  id='choice_45_32_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_14' id='label_45_32_14' class='gform-field-label gform-field-label--type-inline'>Special Fears or Conditions<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_45_32_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.15' type='checkbox'  value='Received a Physical examination in the past 12 months'  id='choice_45_32_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_32_15' id='label_45_32_15' class='gform-field-label gform-field-label--type-inline'>Received a Physical examination in the past 12 months<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_45_33\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_33'>Please describe any Details\/Limitations due to any of the above choices<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_33' id='input_45_33' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_45_35\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_35'>Extra Details<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_35' id='input_45_35' class='textarea medium'  aria-describedby=\"gfield_description_45_35\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_45_35'>Is there anything else we should know about? If so, please describe above, or state \"NONE\"<\/div><\/li><li id=\"field_45_34\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >The Department of Campus Recreation reserves the right in its sole discretion to decline any participants for safety reasons.<\/li><li id=\"field_45_40\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Serious Allergies<\/h2><\/li><li id=\"field_45_36\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_36'>Allergies<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_45_36' class='medium gfield_select'  aria-describedby=\"gfield_description_45_36\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='NO - The participant does NOT have any allergies' >NO - The participant does NOT have any allergies<\/option><option value='NONE - that we are aware of' >NONE - that we are aware of<\/option><option value='YES - The participant has allergies (if yes, please list below)' >YES - The participant has allergies (if yes, please list below)<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_45_36'>Does the participant have any serious allergies?<\/div><\/li><li id=\"field_45_37\" class=\"gfield gfield--type-list field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Medication Allergies (Please list)<\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_37_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_37_col_2' class='gfield_list_col_even' \/><col id='gfield_list_37_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Allergy<\/th><th scope=\"col\">Describe reaction &amp; management of reaction<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_37_cell1' data-label='Allergy'><input aria-invalid='false'   aria-label='Allergy, Row 1' data-aria-label-template='Allergy, Row {0}' type='text' name='input_37[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_37_cell2' data-label='Describe reaction &amp; management of reaction'><input aria-invalid='false'   aria-label='Describe reaction &amp; management of reaction, Row 1' data-aria-label-template='Describe reaction &amp; management of reaction, Row {0}' type='text' name='input_37[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_45_84\" class=\"gfield gfield--type-list gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_84_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_84_col_2' class='gfield_list_col_even' \/><col id='gfield_list_84_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Allergy<\/th><th scope=\"col\">Describe reaction &amp; management of reaction<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_84_cell1' data-label='Allergy'><input aria-invalid='false'   aria-label='Allergy, Row 1' data-aria-label-template='Allergy, Row {0}' type='text' name='input_84[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_84_cell2' data-label='Describe reaction &amp; management of reaction'><input aria-invalid='false'   aria-label='Describe reaction &amp; management of reaction, Row 1' data-aria-label-template='Describe reaction &amp; management of reaction, Row {0}' type='text' name='input_84[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_45_38\" class=\"gfield gfield--type-list field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Food Allergies (Please list)<\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_38_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_38_col_2' class='gfield_list_col_even' \/><col id='gfield_list_38_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Allergy<\/th><th scope=\"col\">Describe reaction &amp; management of reaction<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_38_cell1' data-label='Allergy'><input aria-invalid='false'  aria-describedby=\"gfield_description_45_38\" aria-label='Allergy, Row 1' data-aria-label-template='Allergy, Row {0}' type='text' name='input_38[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_38_cell2' data-label='Describe reaction &amp; management of reaction'><input aria-invalid='false'  aria-describedby=\"gfield_description_45_38\" aria-label='Describe reaction &amp; management of reaction, Row 1' data-aria-label-template='Describe reaction &amp; management of reaction, Row {0}' type='text' name='input_38[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><div class='gfield_description' id='gfield_description_45_38'>Press the [+] on the right to add more<\/div><\/li><li id=\"field_45_85\" class=\"gfield gfield--type-list gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_85_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_85_col_2' class='gfield_list_col_even' \/><col id='gfield_list_85_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Allergy<\/th><th scope=\"col\">Describe reaction &amp; management of reaction<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_85_cell1' data-label='Allergy'><input aria-invalid='false'   aria-label='Allergy, Row 1' data-aria-label-template='Allergy, Row {0}' type='text' name='input_85[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_85_cell2' data-label='Describe reaction &amp; management of reaction'><input aria-invalid='false'   aria-label='Describe reaction &amp; management of reaction, Row 1' data-aria-label-template='Describe reaction &amp; management of reaction, Row {0}' type='text' name='input_85[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_45_39\" class=\"gfield gfield--type-list field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Other Allergies Including Insect Stings, etc. (Please list)<\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_39_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_39_col_2' class='gfield_list_col_even' \/><col id='gfield_list_39_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Allergy<\/th><th scope=\"col\">Describe reaction &amp; management of reaction<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_39_cell1' data-label='Allergy'><input aria-invalid='false'  aria-describedby=\"gfield_description_45_39\" aria-label='Allergy, Row 1' data-aria-label-template='Allergy, Row {0}' type='text' name='input_39[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_39_cell2' data-label='Describe reaction &amp; management of reaction'><input aria-invalid='false'  aria-describedby=\"gfield_description_45_39\" aria-label='Describe reaction &amp; management of reaction, Row 1' data-aria-label-template='Describe reaction &amp; management of reaction, Row {0}' type='text' name='input_39[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><div class='gfield_description' id='gfield_description_45_39'>Press the [+] on the right to add more<\/div><\/li><li id=\"field_45_86\" class=\"gfield gfield--type-list gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_86_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_86_col_2' class='gfield_list_col_even' \/><col id='gfield_list_86_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Allergy<\/th><th scope=\"col\">Describe reaction &amp; management of reaction<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_86_cell1' data-label='Allergy'><input aria-invalid='false'   aria-label='Allergy, Row 1' data-aria-label-template='Allergy, Row {0}' type='text' name='input_86[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_86_cell2' data-label='Describe reaction &amp; management of reaction'><input aria-invalid='false'   aria-label='Describe reaction &amp; management of reaction, Row 1' data-aria-label-template='Describe reaction &amp; management of reaction, Row {0}' type='text' name='input_86[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/web.uri.edu\/campusrec\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_45_47\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >If participant requires medication for allergic reactions, please bring one dose and the participant must present information to URI Campus Recreation approved personnel at check-in of the first day.<\/li><li id=\"field_45_48\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_45_29\" class=\"gfield gfield--type-html gfield_html gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >I CERTIFY THAT THE ABOVE INFORMATION IS TRUE, CORRECT, AND COMPLETE<\/li><li id=\"field_45_42\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_42'>I have read and agree to URI Campus Recreation Consent Form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_45_42' type='text' value='' class='small'  aria-describedby=\"gfield_description_45_42\"  placeholder='Enter initials' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_45_42'>By agreeing electronically, you acknowledge that you have both read and understood all text presented to you in this form.<\/div><\/li><li id=\"field_45_46\" class=\"gfield gfield--type-html gfield_html field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >YOUR SIGNATURE INDICATES COMPLIANCE WITH URI CAMPUS RECREATION MEDICAL CONSENT AND RELEASE POLICIES AND PARTICIPANT HEALTH HISTORY<\/li><li id=\"field_45_49\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_45_49'><li class='gchoice gchoice_45_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='I have read and agree to the Consent Form'  id='choice_45_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_49_1' id='label_45_49_1' class='gform-field-label gform-field-label--type-inline'>I have read and agree to the Consent Form<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_45_50\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_45_51\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Assumption of Risk and Release of Liability Form<\/h2><\/li><li id=\"field_45_52\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >In consideration of my voluntary participation in URI's Department of Campus Recreation's programs and facilities:<\/li><li id=\"field_45_60\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >I confirm I hereby waive, release, fully discharge and quitclaims unto The University of Rhode Island, its governing board, the Rhode Island Board of Education, the State of Rhode Island and their officers, directors, board members, employees, agents, and assignee for any and all liability and claims, or demands and\/or cause of action, that I have or may have for any costs, expenses, or damages, including reasonable attorneys' fees, arising from property damages or personal bodily injury, including death, relating to or arising from my participation in, use of, or operation of equipment related to the Activities or may in the future have, whether known or unknown, arising out of the named Activity.<\/li><li id=\"field_45_59\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >I may or may not have had previous participation experience in the Activity.  I understand and acknowledge that such participation could result in loss of or damage to my or another person's property, serious injury to my body, including mental or emotional injury or trauma and\/or death.  I verify that I have no physical or emotional conditions, which may prevent me from fully participating in the Activity.<\/li><li id=\"field_45_58\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >I understand and agree The University of Rhode Island and its recreational subsidiaries cannot be expected to control all possible risks but may need to respond to accidents and potential emergency situations.  Therefore, I hereby give my consent for any medical treatment that may be required during an attendance with the understanding that cost of any such treatment will be my responsibility.  The University does not carry medical or accidental insurance for the activities mentioned.  As such, participants should review their personal insurance portfolio.<\/li><li id=\"field_45_57\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >I HAVE READ THE WAIVER, RELEASE AND ASSUMPTION OF RISK FORM IN ITS ENTIRETY AND UNDERSTAND THE TERMS AND LEGAL SIGNIFICANCE.  This waiver is freely and voluntarily given with the understanding that right to legal recourse is knowingly given up in return for allowing my participation in the Activity.<\/li><li id=\"field_45_56\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >By signing below, I agree that I have read and understand the above information.<\/li><li id=\"field_45_53\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_53'>I have read and agree to URI Campus Recreation Assumption of Risk and Release of Liability Form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_45_53' type='text' value='' class='small'  aria-describedby=\"gfield_description_45_53\"  placeholder='Enter initials' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_45_53'>By agreeing electronically, you acknowledge that you have both read and understood all text presented to you in this form.<\/div><\/li><li id=\"field_45_61\" class=\"gfield gfield--type-html gfield_html field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >YOUR SIGNATURE INDICATES COMPLIANCE WITH URI CAMPUS RECREATION ASSUMPTION OF RISK AND RELEASE OF LIABILITY FORM<\/li><li id=\"field_45_54\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_45_54'><li class='gchoice gchoice_45_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='I have read and agree to the Consent Form'  id='choice_45_54_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_54_1' id='label_45_54_1' class='gform-field-label gform-field-label--type-inline'>I have read and agree to the Consent Form<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_45_62\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_45_63\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Acknowledgement of Participation Information, Authorization And Release<\/h2><\/li><li id=\"field_45_64\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >1. PARTICIPATION:  In consideration for my voluntary participation at URI Campus Recreation, I hereby acknowledge that I am in good physical and mental health and that unless I have notified the University in writing that I am unable to aprticipate in the activity due to some physical or mental consideration, I will be allowed to participate in all aspects of URI Campus Recreation.<\/li><li id=\"field_45_65\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >2. PHOTOGRAPHS\/VIDEOS\/SOCIAL MEDIA PERMISSION:  I may be photographed (stills and videos), individually or in a group.  We hereby waive and relinquish all rights, title and interest in all such products, and authorize URI Campus Recreation authorized staff to make use of participant's images and likeness for marketing, membership information, and other URI Campus Recreation uses.<\/li><li id=\"field_45_66\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >3. BEHAVIORAL MANAGEMENT:  There are three basic rules that are easy to understand and follow: BE SAFE, BE KIND, AND PARTICIPATE.  We want to foster responsibility, respect, and accountability at URI Campus Recreation so our approach to discipline will reflect this goal.  any discipline will be: constructive in nature, using limits that are fair, consistently applied and understandable for the student.  Campus Recreation Coordinators will communicate with the student if deemed necessary.  if the student continuously displays inappropriate behavior or engages in dangerous activities, the Campus Recreation Coordinator and the Department of Campus Recreation authorized personnel reserve the right to suspend any participant, at any time, without a refund.<\/li><li id=\"field_45_67\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >4. TRANSPORTATION: URI Campus Recreation authorized personnel are not permitted to transport participants by car (or any other type of land transportation), to and\/or from, any off-site activities; and\/or in an event of a medical emergency.<\/li><li id=\"field_45_68\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >I certify as the above named participant, I have reviewed all regulations listed in items #1-#4 above.  I understand all of the terms and conditions of the above, hereby consent, and grant my permission to each and all of the foregoing.<\/li><li id=\"field_45_69\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_69'>I have read and agree to URI Campus Recreation Acknowledgement of Participation Information, Authorization, and Release Form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_45_69' type='text' value='' class='small'  aria-describedby=\"gfield_description_45_69\"  placeholder='Enter initials' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_45_69'>By agreeing electronically, you acknowledge that you have both read and understood all text presented to you in this form.<\/div><\/li><li id=\"field_45_70\" class=\"gfield gfield--type-html gfield_html field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >YOUR SIGNATURE INDICATES COMPLIANCE WITH URI CAMPUS RECREATION ACKNOWLEDGEMENT OF PARTICIPATION INFORMATION, AUTHORIZATION AND RELEASE<\/li><li id=\"field_45_71\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_45_71'><li class='gchoice gchoice_45_71_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_71.1' type='checkbox'  value='I have read and agree to the Consent Form'  id='choice_45_71_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_45_71_1' id='label_45_71_1' class='gform-field-label gform-field-label--type-inline'>I have read and agree to the Consent Form<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_45_78\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_45_79\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Registration Polices<\/h2><\/li><li id=\"field_45_74\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >This URI Campus Rec program is a tuition for service program based on confirmed enrollment and\nsecured deposit. Full registration payments must be received prior to the first day of Activity. All mandatory\nforms must be received by no later than the first day of each Activty.<\/li><li id=\"field_45_75\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Registration application will be accepted on a first come, first serve basis.All online registrations will have convenience fee added\nto the transaction. This amount is added on as a flat fee to your transaction total and goes directly to our\nregistration service provider. The flat fee is only added one time to your total amount, even if you are paying\nfor multiple sessions or campers at that time. If you register separately for each activty session, the\nconvenience fee applies to each transaction. <\/li><li id=\"field_45_76\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >If a medical condition arises, a letter for the doctor is required and will be evaluated by the Director of Campus Recreation\non any partial credit if applicable. Each class will have a limited number of participant spaces available. I\nunderstand no refunds will be made. Returned checks or charges will be assessed a $20.00 fee.\n<\/li><li id=\"field_45_77\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Withdrawal Policy: A withdrawal fee will be assessed for all activities as follows: 25% of registration fee will\nbe credited to client\u2019s account. All withdrawals must be prior to the third class. No credits will be given after\nthe third class.\n \n A 25% withdrawal fee will be assessed for all withdrawals and must notify URI Campus\nRecreation prior to activity.\n<\/li><li id=\"field_45_82\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_45_82'>I have read and agree to URI Campus Recreation Acknowledgement of Participation Information, Authorization, and Release Form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_45_82' type='text' value='' class='small'  aria-describedby=\"gfield_description_45_82\"  placeholder='Enter initials' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' 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