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Sports Club Addendum [click here to download this form in pdf format]

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This form may be printed for reference only.
The official Sports Club Addendum must be submitted electronically.
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  1. A "Sport Club" is defined as a group of Cornell University students, faculty, and staff voluntarily organized for the purpose of furthering and promoting their interest in a particular sport or athletic activity. The club may be recreational, instructional, or competitive in nature. Members display a variety of skill levels and may place varying degrees of emphasis on extramural competition. These groups are student-organized, administered and funded, providing opportunities for student initiative, leadership and development. The executive board and/or officers of the club must be 100% full-time Cornell students. An IO which meets this definition will for the purpose of the attachment be referred to as a "Sport Club IO" and shall receive the benefits enumerated by the University and abide by their provisions as part of this agreement.

  2. The Sport Club IO must complete an injury report form for any injury that occurs during any club sport activity including any injury that occurs during travel to and from the event.

  3. The Sport Club IO must submit a proposed practice schedule and competition schedule to the Student Activities Office by specified dates: Fall semester prior to September 15, Spring semester prior to December 15. This request must be submitted via the normal Use of University Property form supplied by the Student Activities Office.

  4. The Sport Club IO must file current information in the Student Activities Office. This information includes a list of the addresses and telephone numbers of the current club officers; a roster of club sport participants listing their name, address, gender and status; a Release of Liability signed by each club member; and a copy of their constitution.

  5. The Sport Club IO understands and agrees that the University does not assume any responsibility for any injuries to anyone in connection with club activities, whether resulting from club practice or competition, travel or other activities, and that the University will not provide payment for medical care, or provide life or accident insurance coverage for students or others engaged in club activities, whether in Ithaca or away.

    The IO agrees to advise its members that accident medical insurance should be purchased by students from an insurance company. Catastrophic accident insurance may be available based upon a vote of the student governing body representatives. Neither Cornell University nor the student governing bodies make any representation about the availability, completeness, or appropriateness or any insurance coverage. it is the IO's responsibility to verify coverage at the start of each semester and to purchase catastrophic coverage or additional catastrophic coverage if they feel it is appropriate.
  6. The information requested in the IO agreement and addendum is for the purpose of purchasing the insurance policy referred to in Section 6 of the IO agreement and Section 5 of the Sport Club Addendum. The University will endeavor to maintain the confidentiality of the information if requested to do so by the Sport Club IO.

Name of Independent Organization:

_________________________________

Full name of person submitting this form:
(Authorized Organization Officer)

_________________________________

Title within Organization:___________________

Email Address: ___________________________

Today's Date: ____________________________

for CORNELL UNIVERSITY

by: (University Authorized Signatory)

ROXANNE EDSALL-BEEBE
Administrative & Operations Assistant
Student Activities Office
521 Willard Straight Hall
Cornell University
Ithaca, NY 14853
(607) 255-4169

For more information about Student Organizations, contact the Student Activities Office at (607) 255-4169, or email activities@cornell.edu.