Wednesdays at Western Registration Form

WEDNESDAYS AT WESTERN

JUNE 27 - SEPTEMBER 14, 2018 

It is all about you!!!
For security reasons, we ask only for month and date of your birth date. If we need the year, we will contact you.
This could be a course from our Spring catalog, Fall catalog, or a Wednesdays at Western event.
Time to Register
Lunch

Sack lunches are provided by Marios and include a sandwich, bag of chips, cookie, and small bottle of water. 

Safety Stuff

WESTERN STATE COLORADO UNIVERSITY

WAIVER, RELEASE, ASSUMPTION OF RISK AND INDEMNIFICATION AGREEMENT

READ THIS AGREEMENT COMPLETELY BEFORE SIGNING.  BY SIGNING THIS AGREEMENT, YOU RELEASE THE UNIVERSITY FROM ANY LIABILITY RESULTING FROM YOUR PARTICIPATION IN THE ACTIVITIES LISTED BELOW AND WAIVE ALL CLAIMS FOR DAMAGES AGAINST THE UNIVERSITY.

MEDICAL DISCLOSURE, DISCLAIMER, AND RELEASE

By electronically signing my name, I give consent for emergency medical treatment for me if it becomes necessary as a result of my participation in the Extended Studies program. The information provided above is a complete and accurate statement of the physical and psychological factors that may affect my participation in the programs. I realize that failure to disclose such information could result in serious harm to me and /or my fellow students/participants. I agree to indemnify and hold harmless Western State Colorado University if all relevant information is not disclosed. I also agree to notify Western State Colorado University should there be any change in my health status prior to or during the program.

MEDIA AND PHOTO RELEASE 

The University maintains a database of photographs from campus events, activities and other college-related purposes.  The University provides those photographs to the media and also uses them in publications, on the website and other publicity purposes for the University. 

THANK YOU! 

Thank you for registering with the Extended Studies Department.  A confirmation email containing the total amount due will be sent in 2 business days.  If you do not received your confirmation email, please contact the Extended Studies Department at extendedstudies@western.edu