Assumption of Risk (AOR) Form - Xavier University 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name and Banner ID at the top of the form. Ensure that you type or print clearly for legibility.
  3. Fill in the entities providing your professional field experience, along with your department and academic year. This information is crucial for identifying your specific experience.
  4. List the off-campus locations where your experience will take place, followed by the dates of your experience. This helps clarify where and when you will be participating.
  5. Read through each section carefully, especially the Participation Acknowledgement and Assumption of Risks sections. These outline important responsibilities and potential risks associated with your experience.
  6. Complete the Emergency Contact Information section, ensuring that you provide accurate details for two contacts in case of an emergency.
  7. Review and fill out any health history or medical insurance coverage information as required. This ensures that Xavier is aware of any health issues that may arise during your participation.
  8. Finally, sign and date the form at the bottom. If you are under 18, ensure a parent or guardian also signs where indicated.

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An assumption and release agreement is a contract between two parties where one party assumes a responsibility relinquished by the other. Within the agreement, specific details regarding whatd being surrendered and under what conditions is typically included in the verbiage within the contract.
If I choose to participate in this event, I voluntarily assume all responsibility and risk, including but not limited to all risk of loss of limb or life; physical and emotional injuries; serious illness such as infectious and non-infectious diseases and/or conditions arising from my participation in this event or SAMPLE ASSUMPTION OF RISK RELEASE [FILL IN EVENT] [FILL IN Emporia State University documents Sample-Assump Emporia State University documents Sample-Assump
Key Elements of Assumption of Risk Knowledge of the risk: The individual must be aware of the potential dangers involved. Voluntary participation: The person must willingly engage in the activity despite knowing the risks. Understanding of consequences: There should be a clear comprehension of the potential outcomes.
I hereby assume full responsibility for and risk of bodily injury, death or property damage (whether due to ordinary negligence or otherwise) arising in connection with my observation, participation in physical activities and use of the Facility facilities and equipment.

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