Sample Intramural Permission & Acknowledgement of Elements of Risk Form

This sample form for permission and acknowledgment of elements of risk is meant for schools to include within their forms used for parental/guardian permission for internet use and permission to photograph their child/ward or within a digital system used by the school board (for example, Power School, My Blue Print etc.) at the beginning of the school year. Consult Intramural Permission for more information.

Intramural activities are defined as school-sponsored physical/recreation activities that occur outside the student's instructional time and are not competitions against other outside teams/groups. They may include Sports Games and Sport Imitations, Low Organization Activities, Drop-In Physical Activities, and some Special Events and Clubs.

(Include the list of expected intramurals for the school year here.)

Elements of Risk

In all physical activities there is an element of risk. Accidents/injuries may result from the nature of the activity and can occur without any fault on either the part of the student, or the school board or its employees or agents or the facility where the activity is taking place. Injuries may range from minor sprains and strains to more serious injuries (for example, concussion). Participants assume this risk but reduce the chance of an accident/injury occurring by carefully following instructions at all times during the activity.

I acknowledge and have read the Elements of Risk and I give my child/ward permission to participate in intramurals.

Parent/Guardian Signature: