National University Student Organization Registration Form with Liability

Student Organization Registration & Liability Form

All club members must fill out one form per member. Clubs must maintain at least five active members and sufficient officers to execute organizational duties.
Your Name*

First NameLast Name
Your NU Student ID*
Your student ID is a 9 or 10-digit number.
Your Email Address*
example@example.com
Please select the approximate date you first became a member of any student organization at National University:
I am*

An active studentAn alumnus
Please select all of the student organizations of which you would like to join or are already a part of. [Please note we are NOT affiliated with entities such as NSLS, Golden Key, etc.]*

NUSNA - San DiegoNUSNA - FresnoNUSNA - Los AngelesCybersecurity TeamCTS Student OrganizationPRIDEOmegaNUPlanetree Student CommitteeStudent Veteran OrganizationPublic Health Student OrganizationHealthcare LeadersMind & Body Wellness Student OrganizationEducators UnitedPhi Alpha Delta - Pre-LawPhi Alpha Delta - Rose Bird ChapterStudent Social Work AssociationAlpha Phi Omega (APO)New/Unlisted Student Organization (please indicate the name below)
If you selected New/Unlisted Student Organization, please put the org name here.
Please select all of the student organizations of which you are an OFFICER:

I am not an officer in any National University student organization.NUSNA - San DiegoNU SNA - FresnoNUSNA - Los AngelesCybersecurity TeamPRIDEOmegaNUFamilies UnitedPlanetree Student CommitteeGraduate Student Nurses AssociationStudent Veteran OrganizationPublic Health Student OrganizationAmerican Marketing AssociationHealthcare Administration Student OrganizationRadiation Therapy Student OrganizationInternational Students AssociationRobotics ClubClinical Laboratory SciencesMind & Body Wellness Student OrganizationEducators UnitedOther
What is your anticipated graduation date? Please enter an approximate date if you are not sure of the exact date.*
National University Release of Liability and Waiver of Rights

All students must have an up-to-date and complete waiver on file to be eligible to participate in National University co-curricular activities.
BY SIGNING THIS DOCUMENT I HEREBY WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE NATIONAL UNIVERSITY, A CALIFORNIA NON-PROFIT CORPORATION, NATIONAL UNIVERSITY STUDENT ORGANIZATION, A CALIFORNIA NON-PROFIT CORPORATION, COLLECTIVELY (”Sponsors”).

Activity: Participation in National University Student Organization
Please select the student organization that you are a part of. If you are a member of multiple student organizations, please select your primary affiliation:*
Example: Student Nurses Association- San Diego
I desire to participate in the activity described above (the “Activity”), including, without limitation, to drive or be a passenger in any vehicle (automobile, boat or other conveyance), whether it is owned by Sponsors, me, or any other party, or otherwise enter any area where the Activity takes place, or to observe or otherwise participate in or in any other way be involved for any purpose with the Activity. In consideration of being permitted to participate in the Activity, I hereby agree to all the terms of this Release of Liability and Waiver of Rights (this “Release and Waiver”), including all the covenants and agreements listed on this form.

I specifically acknowledge and agree that this document is not intended to be a general release subject to limitations and conditions that would otherwise apply under applicable state laws, ordinances, statutes, rules, and regulations (collectively, “Applicable Law”), and additionally agree to WAIVE ANY AND ALL GENERAL RELEASE LIMITATIONS PROVIDED BY APPLICABLE LAW OR ANY RIGHTS GRANTED TO ME UNDER APPLICABLE LAW. This Release and Waiver shall be construed and interpreted as broadly as possible under the Applicable Law of the jurisdiction in which the Activity takes place.

This Release and Waiver shall be binding upon and enforceable against me, my personal representatives, spouse, assigns, heirs, and next of kin without limitation. It is my desire and intent that the words, terms, provisions, covenants, and remedies contained in this Release and Waiver shall be enforceable to the fullest extent permitted by Applicable Law. If any portion of this Release and Waiver is held invalid, the remainder shall not be affected and shall continue in full legal force and effect; that shall include modifying the Release and Waiver to allow any remaining claims to be waived, released, and indemnified against in the event that the inclusion of any particular provision is found to be invalid or contrary to public policy. The terms of this Release and Waiver shall continue from this date forever. This document constitutes the entire agreement between Sponsors and me and supersedes any previous or contemporaneous discussions or agreements between us in respect of these matters.

I hereby irrevocably and unconditionally agree for myself, my personal representatives, my heirs, next-of-kin, insurers, successors, and assigns, as follows:

1. ASSUMPTION OF RISK. My choice to participate in the Activity (Participation in Student Organization) is knowing, voluntary, and made for my personal enjoyment. I understand that participation in the Activity involves inherent risks and dangers of accidents, rescue operations, emergency treatment, property loss or damage, serious personal and bodily injury, death, and severe personal and economic losses. These may result not only from my own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others, or the condition of the facilities, equipment, or vehicles. Further, there may be other risks not known to me or reasonably foreseeable at this time. I understand and I have considered the risks involved, and I voluntarily and freely choose to assume these risks.
Initial here:*
The initials for your first, middle, and last names.
2. RELEASE FROM LIABILITY. I fully and forever release and discharge Sponsors and its respective affiliates, directors, officers, trustees, shareholders, employees, agents, and insurers, and all others involved in the Activity (collectively referred to in this Release and Waiver as “Sponsors”) from any and all injuries (including death), losses, damages, claims (including negligence claims), demands, lawsuits, expenses, and any other liability of any kind, of or to me, my property, or any other person, directly or indirectly arising out of or in connection with my participation in the Activity, even if it is due to the negligence, injudicious act, omission, or other fault of Sponsors.
Initial here:*
The initials for your first, middle, and last names.
3. INDEMNITY. I will defend, indemnify, hold harmless, and reimburse Sponsors from and for all damages, losses, costs, or expenses (including legal fees) incurred by Sponsors or paid by them to any person (including me or my insurers) in respect of any accident, injury (including death), loss, or property damage, however caused resulting from, arising out of, or otherwise in connection with my participation in the Activity. I will reimburse Sponsors if anyone makes a claim against Sponsors in connection with my participation in the Activity, including, without limitation, any accident I may be involved in or any injury, loss, damage to me, other parties or property however caused.
Initial here:*
The initials for your first, middle, and last names.
4. COVENANT NOT TO SUE. I will not initiate any claim, lawsuit, court action, or other legal proceeding or demand against Sponsors, nor join or assist in the prosecution of any claim for money or other damages which anyone may have, on account of injuries (including death), losses, or damages sustained by me, other parties, or my (or others') property in connection with my participation in the Activity, and I waive any right I may have to do so. This means that I cannot sue to hold Sponsors responsible for any injury, loss, or damage sustained by me, other parties, or my (or others') property in connection with the Activity, even if it is due to the negligence, injudicious act, omission, or other fault of Sponsors. I waive my insurers' right to make a claim against Sponsors based on payments by insurers to me or on my behalf for any reason. This means my insurers have no rights of subrogation against Sponsors.
Initial here:*
The initials for your first, middle, and last names.
5. MEDICAL EXPENSES. I hereby consent to receive medical treatment which may be deemed necessary in the event of any illness, accident, or injury, or medical emergency resulting from or in connection with my participation in the Activity and understand that I am solely responsible for all costs related to such medical treatment, medical transportation, and/or evacuation.
Initial here:*
The initials for your first, middle, and last names.
6. REPRESENTATIONS. I am over 18 years of age and am in good health, in proper physical condition, and I do not have any medical or other conditions that would impair my ability to drive or ride in a vehicle or otherwise participate in the Activity. If at any time I believe conditions to be unsafe or that I am no longer in proper physical condition to participate in the Activity, I will immediately discontinue further participation in the Activity.
Initial here:*
The initials for your first, middle, and last names.
7. COVENANTS. I will follow any and all instructions, recommendations, and cautions of Sponsors at all times during the Activity, including, without limitation, in respect of my operation of any vehicle at the Activity or other participation in the Activity. I will comply with all Applicable Laws while participating in the Activity. I will operate all vehicles at the Activity in a safe manner and will observe all traffic laws. I will not operate or be a passenger in any vehicle at the Activity while under the influence of any alcohol or illegal drug, or any intoxicant, narcotic, prescription medicine, or other drug which would impair my ability to operate or ride in a vehicle.
Initial here:*
The initials for your first, middle, and last names.
8. PUBLICITY. I hereby grant Sponsors and CSEA, without limitation, the right to use my name and likeness in connection with the Activity for any publicity without further compensation or permission.
Initial here:*
The initials for your first, middle, and last names.
I HAVE READ THIS RELEASE AND WAIVER, FULLY UNDERSTAND ALL THE TERMS, UNDERSTAND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS BY SIGNING BELOW, AND HAVE SIGNED THIS RELEASE FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT, ASSURANCE, OR GUARANTEE OF ANY NATURE BEING MADE TO ME.

I HEREBY WARRANT THE TRUTH OF THE ABOVE STATEMENTS AND I DECLARE THAT I HAVE NOT WITHHELD ANY INFORMATION THAT WOULD INFLUENCE THE DECISION OF SPONSORS IN ALLOWING ME TO PARTICIPATE IN THE ACTIVITY, INCLUDING, WITHOUT LIMITATION, TO DRIVE ANY VEHICLE PROVIDED BY ME, SPONSORS, OR OTHER PARTIES.

BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THE COVENANTS AND AGREEMENTS AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE SPONSORS.
Your full name (printed):*
Today's Date:*

MonthDayYear
I opt-in to receiving email communications about club events.*

Yes! Send me info about club and CSEA events!Please don't send me emails about club or CSEA events.I want the info. Text me instead.
Send me info via text here.
Please by signing below, I verify the above is true and correct. Sign here by left-clicking and using your mouse as a stylus:*

Clear
Please email clubs@nu.edu with any questions regarding this form.
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Student Organization Registration & Liability Form