Prospective Student-Athlete Overnight Visit Form

Franklin College Department of Athletics Prospective Student-Athlete Overnight Visit

As a prospective student-athlete of Franklin College, you are a valued guest on our campus. Your safety is our priority, and we want you to have a positive experience while you are here. Please read the following set of expectations. In order to provide you with an overnight experience on our campus, you must agree to abide by these expectations and conduct yourself in a mature and professional manner. Your signature reflects that agreement for the duration of your campus visit.

As our guest and the guest of your student host(s), you agree to follow all campus regulations for appropriate student conduct and all NCAA rules governing an official campus visit. If you would like to review the student-athlete conde of conduct, it can be found by accessing the student-athlete handbook at the following link: Student-Athlete Handbook Further resources from the NCAA are available free at https://www.ncaapublications.com/p-4607-2020-2021-ncaa-division-iii-manual.aspx.

You have been provided with contact information for the coach of your sport, and you understand that you are free to contact the coach at any time during your visit if an issue or situation arises which you feel is unsafe, unwise or simply uncomfortable.

You acknowledge that the use of alcohol during your campus visit is not only a violation of Indiana state law, but also campus regulations and athletic department policy.

Name*

First Name

Last Name

Email*

Your Phone Number*

Age*

Sport Hosting Your Overnight Visit*

Date of Overnight Visit*

Signature*

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Use your mouse or finger to draw your signature above

Date/Time*

Emergency Contact Information

Overnight Participant's Name*

First Name

Last Name

Birth Date*

Gender*

Parent/Guardian Name*

First Name

Last Name

Parent Phone Number*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Insurance - Name of Insured individual*

Insurance Company*

Insurance Number*

Insurance Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Family Physician Name*

First Name

Last Name

Physician Phone Number*

Please list any allergies

Franklin College Parental Permission/Liability Waiver Form

(Optional if prospective student-athlete is 18 years of age or older)

I/We grant permission for my/our son/daughter (named above) to participate in an overnight visit to Franklin College of Indiana (College). I/We further certify that he/she is in good physical health for such participation as verified by a physician’s examination administered during the past twelve months. I/We agree to indemnify, save, and hold harmless the College, its Board of Trustees, officers, employees, and agents against any and all property losses and/or judgments rendered against the event. I/We also agree to release, waive and discharge the College, its Board of Trustees, officers, employees, and agents from any and all liability to the undersigned, his/her, or their personal representatives, assigns, heirs, and next of kin for any and all loss or damage, and any claim or demands therefore, on account of injury to the person or property of, or resulting in the death of, the undersigned’s child or ward arising out of or related in any way to the undersigned’s child’s or ward’s participation in or presence at event. I/We further grant permission for my/our son/daughter to be treated by a local physician or hospital emergency room personnel if necessary. Note: Verbal permission may still be required before your son/daughter can be treated by a local physician or ER personnel.

Parent/Guardian Signature

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Use your mouse or finger to draw your signature above

Date/Time