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Maryville College

MaryVille Portal - MVP!

    Mountain Challenge Release Form

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    As part of the Expanding Horizons program, incoming students will participate in activities facilitated by Mountain Challenge, which provides high quality, safe outdoor experiences designed to enhance student learning and transition to college. 

    Mountain Challenge Participant Info
    Are you currently under the age of 18?
    Are you currently under the age of 18?
    Birthdate
    Birthdate
    Mailing Address
    Mailing Address

    Parent/Guardian Info
    Parent/Guardian Address
    Parent/Guardian Address

    PART II. EMERGENCY INFORMATION

    In case of emergency contact:

    PART III. MEDICAL HISTORY

    What kind?
    What kind?

    PART IV. CONSENT

    My signature below indicates I understand that during my Mountain Challenge course I may be exposed to above normal risks which may include exposure to heights, moving water, underground environments, extreme weather conditions, and/or wilderness settings. Furthermore, I understand that although Mountain Challenge has taken precautions to provide safe equipment and qualified staff for each course, it is impossible for Mountain Challenge to guarantee absolute safety. I share the responsibility for safety on the course and I assume that responsibility. I agree to comply with the instructions of the Mountain Challenge staff members during the course. I consent to Maryville College and Mountain Challenge using the names and addresses in this document to send additional information.

    PART V. RELEASE AND HOLD HARMLESS AGREEMENT

    In consideration of and as part payment for the opportunity to participate in this trip, I have and do hereby release and will hold harmless Mountain Challenge. LLC and Maryville College and all its officers, employees and agents, from any and all liability, actions, causes of actions, debts, claims and demands of every kind and nature whatsoever, including attorney fees, and specifically including any claim for negligence or negligent acts, which I now have or which may arise out of or in connection with my trip or participation in this activity. The terms hereof shall serve as a release, indemnification, and assumption of risk for my heirs, executors, and administrators and for all members of my family, including any minors accompanying me.

    PART VI. EMERGENCY CARE AUTHORIZATION

    My signature below authorizes Mountain Challenge staff to take measures which in their judgement are reasonable and necessary in the event I require medical attention:
     


    By signing this Electronic/Digital Signature form, I agree that my electronic/digital signature is the legally binding equivalent to my handwritten signature and has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic/digital signature or claim that my electronic/digital signature is not legally binding.
    Maryville College
    800.597.2687
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    502 E. Lamar Alexander Pkwy
    Maryville, TN, 37804

    © All information Maryville College 2022 Legal | Contact Us | Title IX | Consumer Information

    502 E. Lamar Alexander Pkwy, Maryville, TN, 37804

    © All information Maryville College 2026
    Legal | Contact Us | Title IX | Consumer Information