MCC Apartments Fitness Center Waiver



I, , the undersigned do hereby agree to release, discharge, and hold harmless Eastern Iowa Community College District (hereinafter "district") and its officers, employees, and agents from any and all claims, demands, causes of action, judgments, costs, and any liability whatsoever related to my participation in or use of the MCC Apartments fitness center (hereinafter "fitness center") located at Muscatine Community College's Nyweide-Scott Apartments.

I also represent that any exercises, exercise techniques or equipment, either district owned or donated that I choose to utilize are strictly of my own selection and are not chosen in reliance upon any advice or representation of any district agent or employee.

I fully understand that my participation in or use of the activity center is my own voluntary decision.

I certify that I am in good physical health and am capable of engaging in my intended course of exercise in a safe and healthy manner. I understand the risks inherent in engaging in physical exercise and acknowledge that it is exclusively my responsibility to seek from my own physician a medical evaluation and clearance before engaging in any physical exercise.

This waiver and release of liability shall apply to any right of action that might accrue to me, my heirs, and personal representatives. I agree to assume all risks inherent to participation in physical activity classes and events, including the risk of injury caused by malfunctioning or improperly maintained equipment.

I, , hereby certify that I have read and understand the contents of the Release and Waiver and desire to be bound by its terms.


By entering your name you are signing this document.

It is the policy of Eastern Iowa Community College District not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental or marital status, as required by the Iowa Code §§216.6 and 216.9, Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d and 2000e), the Equal Pay Act of 1973 (29 U.S.C. § 206, et seq.), Title IX (Educational Amendments, 20 U.S.C. §§ 1681-1688), Section 504 (Rehabilitation Act of 1973, 29 U.S.C. § 794), and Title II of the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.).

If you have questions or complaints related to compliance with this policy, please contact Debora J. Sullivan, Equal Employment Opportunity Officer/Equity Coordinator, Eastern Iowa Community College District, 101 West Third Street, Davenport, Iowa 52801, 563-336-3487, djsullivan@eicc.edu or the Director of the Office for Civil Rights, U.S. Department of Education, Citigroup Center, 500 West Madison Street, Suite 1475, Chicago, Illinois 60661-7204, phone number 312-730-1560, fax 312-730-1576, OCR.Chicago@ed.gov.