EMORY UNIVERSITY
ASSUMPTION OF RISK AND RELEASE FOR U.S. TRIP
The parties to this agreement are Emory University and the student identified more fully below, who will be referred to as “Student” in the rest of this agreement. If Student is a minor, then the Student’s parents are also parties to this agreement.
Emory University has made arrangements that will permit Student to engage in the following activity, which will include travel off of Emory’s campus: [INSERT DESCRIPTION OF TRIP]. For ease of reference this activity will be described as the “Activity” in the rest of this agreement.
The Activity may involve substantial risks of bodily injury, property damage, and other dangers. Each Student participating in the Activity should realize and is hereby advised that there are risks, hazards, and dangers inherent in the Activity and in any training, preparation for, and travel to and from the Activity. Student is responsible for researching and evaluating the risks Student may face and for all of Student’s actions. Any action or decision of Student in the course of the Activity, whether as a component of the Activity or separate from it, will be considered to have been undertaken with Student’s approval and understanding of all risks involved. Student agrees to abide by all policies, rules, and regulations of Emory and all laws, regulations, and rules of any area visited as part of the Activity. Student understands and acknowledges that, in its sole discretion, Emory may terminate Student’s participation in the Activity at any time, including before departure or during the Activity. Reasons for termination may include, but are not limited to, any inappropriate conduct by Student deemed detrimental to the best interests of the Activity.
Each Student participating in the Activity must be covered by an accident and health insurance policy. Student acknowledges that Emory is not providing him or her with any insurance, whether health, accident, or otherwise, in connection with the Activity. It is the responsibility of each Student to participate only in the parts of the Activity for which he or she has the prerequisite skills, qualifications, preparation, and training. Emory does not warrant or guarantee in any respect: (1) the competence or mental or physical condition of any instructor, trip leader, vehicle driver, or individual participant connected with the Activity; (2) the physical condition of any of the equipment used in connection with the Activity or travel to and from the Activity; or (3) the suitability of the Activity for Student’s participation.
Student hereby acknowledges and agrees that participation in the Activity involves an inherent risk of physical injury, damage to property, or both, and that Student has been advised concerning such risks. In consideration for being permitted to access and participate in the Activity and for the benefits received from participation in the Activity, Student voluntarily assumes all risks of damages or injury, including death, that may be sustained by him or her or by his or her property while participating in the Activity or in any travel to or from the Activity.
If, during Student’s participation in the Activity, Student becomes incapacitated or otherwise unable to provide consent to medical treatment and advance consent cannot be obtained from Student’s family, Student agrees that medical treatment may be performed when, in the opinion of competent medical personnel, the health or welfare of Student will be adversely affected by any delay. In such event, Student authorizes the Emory representative directing the Activity to grant permission for the necessary medical treatment of Student.
Student acknowledges that he or she has chosen to participate in the Activity and that participation in this Activity is not required in any way by Emory University.
RELEASE, COVENANT NOT TO SUE, AND WAIVER
For the sole consideration of Emory allowing Student to participate in the Activity, Student, on behalf of himself or herself as well as Student’s heirs, representatives, executors, administrators, and assigns, agrees to and does hereby release, relieve, covenant not to sue, and forever discharge Emory of and from all Claims (as that term is defined below). The term “Claims” shall mean claims, demands, rights, liabilities, losses, expenses, and causes of action of whatever kind or nature (including, but not limited to, negligence, foreseen and unforeseen bodily and personal injuries, damage to property, and the consequences thereof) resulting from any participation in the Activity, transportation to or from the Activity, or in any way connected with the Activity. For the purpose of this paragraph, “Emory” shall mean and include Emory University, all its affiliated entities, and each of their trustees, officers, agents, employees, coaches, students, and any volunteers participating in the Activity.
Student agrees to indemnify Emory for and hold Emory harmless from any financial liability and obligation that Student personally incurs, and for any injury, loss, damage, liability, cost or expense to the person or property of any third party that is caused or contributed to by Student during or as a result of Student’s participation in the Activity.
Student recognizes and agrees that Emory assumes no responsibility for any damage or injury that may be caused by Student (including Student’s negligence or willful acts) during or in any way connected to the Activity, or for any damage or injury caused to any other participant in the Activity or persons involved with or encountered during the Activity (including any intentional or negligent acts or omissions of any such person).
By signing this document, Student hereby acknowledges that Student has read the above carefully before signing, and agrees to comply with all the above this ______day of ______, 20___.
Signature Address
Print Name
[Required signature for parent or guardian of minor students follows]
Parent or Legal Guardian Consent (if participant is not age 18 or older): I, as parent or guardian of the above minor under 18 years of age, hereby consent, on behalf of the said minor, to the terms and conditions set forth in this Assumption of Risk and Release.
Sign Date
Age of Participant______Phone Number of Parent or Legal Guardian ______
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Rev. 2/2007