Wilderness First Responder Course Form









Emergency Contact Information








By our signatures below, we acknowledge that we are aware of, appreciate the character of, and voluntarily assume the risks involved in participating in a Wilderness First Responder course, as detailed on the National Outdoor Leadership School, Wilderness Medicine Institute’s Student Agreement Form.


By our signatures below, on behalf of ourselves, our heirs, next of kin, successors in interest, assigns, personal representatives, and agents, we hereby:

  1. Waive any claim or cause of action against and release from liability the State of South Dakota, its officers, employees, and agents for any liability for injuries to person or property resulting from participation in the activity listed above;
  2. Agree to indemnify and hold harmless the State of South Dakota, its officers, employees, and agents for any claims, causes of action, or liability to any other person arising from participation in the activity listed above;
  3. Consent to receive any medical treatment deemed advisable during participation in the activity listed above; and
  4. Acknowledge that we are signing below as a minor child and as the parent or legal guardian of the minor child named below.
  5. Give consent for BHSU to take photographs of me or my minor in connection with the above identified program, and agree that BHSU may use such images with or without a name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.