IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING. ASSUMPTION OF
RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT |
This Agreement must be completed in order to participate in the activities associated with this program and course. |
Participant (print full name):___________________________________________________ |
Program: Walking field trip Feb 12, 2011 to Fault line Park . |
Course:_GEOG3600 – GEOGRAPHY of |
I, the undersigned, am either the Participant named above or the parent and/or legal guardian ("Guardian/Parent") of the minor Participant named above. I am familiar with the curriculum and the activities which take place in the above named course. |
TERMS AND CONDITIONS |
I will participate or authorize
the Participant to participate in the above program and course at the |
WAIVER, RELEASE AND INDEMNIFICATION |
Participant or Guardian/Parent
of Participant understands and acknowledge that the |
Participant of Guardian/Parent of Participant agrees that the site of any lawsuit arising out of or related to participation in the Program shall be Utah and that this Agreement will be governed by and construed in accordance with the laws of the state of Utah, without application of any principles of choice of law. |
Participant does not have any medical conditions that would prevent participation in course Program. |
Participant has adequate health insurance to cover the costs of treatment in the event of any injury. Participant shall pay any attorney fees or costs incurred by the University in enforcing this Agreement. If any portion of this Agreement is held to be invalid by a court of law, then it is agreed and intended that all the remainder shall, notwithstanding, continue in full force and effect. |
PARTICIPANT OR GUARDIAN/PARENT OF PARTICIPANT HAS CAREFULLY READ THESE TERMS AND FULLY UNDERSTANDS THEIR CONTENT AND IS AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN PARTICIPANT OR GUARDIAN/PARENT OF PARTICIPANT AND THE RELEASEES AND SIGNS IT OF HIS OR HER OWN FREE WILL. |
I am signing this Agreement for myself as Participant. I acknowledge that I am eighteen (18) years of age and that I understand the terms of this Agreement. I also acknowledge that this Agreement shall bind my heirs and personal representatives. _____________________________________________ ________ Signature of Participant Date |
I am signing this Agreement on behalf of a minor Participant. I acknowledge that I am the Guardian/Parent of the Participant and that I understand the terms of this Agreement. I also acknowledge that these terms shall bind my heirs and personal representatives and the heirs and personal representatives of Participant. _____________________________________________ ________ Signature of Legal Guardian and/or Parent of Participant Date |
Participant's Insurance I.D. number and insurance carrier, carrier address and phone number: NOT required to fill out for 2011. |
|