Access Card Request – Human Resources

To be completed by the person from whom building access is requested.

Caution: Read completely before signing. Domestic partners must have an approved Affidavit of Domestic Partnership on file in Human Resources before an access card will be provided.

Which most closely describes your relationship with Kalamazoo College?(Required)

“Partner” refers to domestic partner as defined at https://hr.kzoo.edu/benefits/healthcare/domestic-partner/.

I am a (soon-to-be) retired faculty or staff member of Kalamazoo College.

I am the spouse/partner of an active/retired faculty or staff member.

Other

Name of your spouse/partner.(Required)

Must be an active or retired faculty/staff member of Kalamazoo College.

First Last

Name of Person Requesting the Access Card(Required)

First Last

Email(Required)

Requestor's Date of Birth(Required)

Used to verify record in Human Resources

Requestor's Social Security Number(Required)

Used to verify records in Human Resources

Address(Required)

This is where the access card will be sent.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Upload photo(Required)

Upload a clear, front-facing, head and shoulders photo of yourself. Non-viable photos will delay card production.

Accepted file types: jpg, png, gif, Max. file size: 5 MB.

Kalamazoo College Athletic Facilities Waiver of Liability and Assumption of Risk and Indemnity(Required)

I understand that picture identification is required. I have read this Waiver, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I have the opportunity prior to signing this Waiver to have it reviewed by my attorney. I know, understand and appreciate these and other risks that are inherent in the Activity. I expressly agree and assert that my participation in the Activity is voluntary and I knowingly assume all such risks and elect to proceed with the participation despite all the risk. I acknowledge that I am signing this Waiver freely and voluntarily and intend, by my signature, the complete and unconditional release of all liability to the greatest extent allowed by law. In consideration of the acceptance of my participation in the Activity, I hereby agree to abide by all applicable rules and regulations and codes of the College.

In consideration of being permitted to use, perform and/or participate in any activity, including those activities and/or classes offered remotely in an online or other format, in any way at or through the Kalamazoo College Athletic Facilities, including, at the sole discretion of Kalamazoo College (the “College”), the following: (i) the Kalamazoo College Fitness & Wellness Center, (ii) the Natatorium, and/or (iii) the Anderson Athletic Center (the “Activity”), the undersigned (“I” or “Participant”), for myself, my heirs, personal representatives and assigns, agree to the following terms in this Waiver of Liability, Assumption of Risk and Indemnity (this “Waiver”):

A. Physical Fitness. I (1) acknowledge that the Activity involves exercise requiring physical fitness; and (2) certify that I am in good physical health for the purpose of participating in the Activity.

B. Waiver and Release; Indemnification. I, on behalf of myself, my personal representatives, heirs, executors, administrators, agents, and assigns, hereby fully release, waive, forever discharge, and covenant not to sue or claim against the College, its board members, trustees, officers, directors, affiliates, faculty, employees, representatives, agents, volunteers, successors and assigns (collectively, the “Releasees”) for any and all liability of whatever kind or nature, including any and all claims, demands, causes of action, suits, or judgments of any and every kind (including attorneys’ fees and costs and expenses), arising from any loss, injury (including death) or property damage that I may suffer as a result of the Activity, or any travel to or from the Activity, or any activity in connection with the Activity, regardless of whether the injury or damage is caused by the negligence of those whom I have released or otherwise. I agree to indemnify, defend and hold harmless the College, its board members, trustees, officers, directors, affiliates, faculty, employees, representatives, agents, volunteers, successors and assigns, for any and all losses, damages, liabilities, costs, or expenses of whatever kind incurred during the Activity.

C. Assumption of Risk. I AM AWARE AND UNDERSTAND THAT THE ACTIVITY IS A POTENTIALLY DANGEROUS ACTIVITY AND INVOLVES THE RISK OF SERIOUS INJURY, DEATH, DISEASE AND/OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT THESE RISKS MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF RELEASEES OR OTHERS, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE RELEASEES. I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE ACTIVITY WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DEATH, DISEASE OR PROPERTY DAMAGE, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

D. Medical Release. I hereby consent to receive medical treatment deemed necessary if I am injured or require medical attention during participation in the Activity. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation. For classes, activities or instruction being offered remotely through online or other media, I understand that I am solely responsible for emergency first aid and other medical procedures that may be required in the event of injury. I hereby release, forever discharge, and hold harmless the College from any claim based on such treatment or other medical services.

E. Choice of Law and Jurisdiction. I understand and expressly agree that (1) this Waiver, or any action or claim relating to this Waiver or the Activity, shall be governed by the laws of the State of Michigan without regard to the laws of conflict of law thereof; and (2) any action or claim relating to this Waiver or the Activity shall be initiated and maintained in a municipal or state court in Kalamazoo County, Michigan, or the United States District Court for the Western District of Michigan.

F. Entire Agreement. The parties agree that this Waiver (a) is the complete and exclusive statement between the parties with respect to this matter, (b) supersedes all related discussions and other communications between the parties with respect to such matter, and (c) may only be modified in writing by an authorized representative of the party against whom such alteration or modification is sought to be enforced. The Director of Advancement Events is the authorized representative for the College.

G. Severability. I further understand and agree that even if a court of law finds any provision or aspect of this agreement unenforceable, the remaining provisions will remain in full force and effect. Furthermore, I understand and agree that if there is any unenforceable provision or aspect, it will be construed, to the extent possible, to make it enforceable and within public policy.