LIABILITY WAIVER:
You have agreed to allow your child to participate in the SCRUBS Camp. You understand that as part of the Camp, your child may have the opportunity to participate in various other activities such as field trips, facility visits and hiking and/or other outdoor activities. You are aware of the dangers and risks that might occur while participating in these activities. Risks associated with participation in these activities include, but are not limited to, loss of or damage to personal property, bodily injury, or even death. All such risks are known, understood, and assumed by you. In consideration of the University's agreement, you permit your child to participate in these activities, you agree as follows: 1) You represent and warrant that your child is covered by a policy of comprehensive health and accident insurance which provides coverage for illnesses or injuries your child may sustain or experience and provides coverage for emergency medical evacuation and for repatriation of remains. By your signature below, you certify that you have confirmed that your health insurance policy will adequately cover your child; and you hereby release and discharge the University of all responsibility and liability for any injuries, illnesses, medical bills, charges or similar expenses, emergency evacuation expenses, and repatriation related expenses that your child incurs while participating in the Camp. 2) You, individually, and on behalf of your heirs, successors, assigns and personal representatives, hereby release and forever discharge the University and its employees, agents, officers, trustees and representatives (in their official and individual capacities) ("Releases") from any and all liability whatsoever for any and all damages, losses or injuries (including death) your child sustains to person or property or both, including but not limited to any claims, demands, actions, causes of action, judgments, damages, expenses and costs, including attorney fees, which arise out of, result from, occur during, or are connected in any manner with your child's participation in the camp incident thereto, whether caused by the negligence of the Releases or otherwise; except that which is the result of gross negligence and/or wanton misconduct by the Releases. 3) You, individually, and on behalf of your heirs, successors, assigns and personal representatives, hereby agree to indemnify, defend and hold harmless the College/University and its employees, agents, officers, trustees and representatives (in their official and individual capacities) from any and all liability, loss, damage or expense, including attorney fees, that they or any of them incur or sustain as a result of any claims, demands, actions, causes of action, damages, judgments, costs or expenses, including attorney fees, which arise out of, occur during, or are in any way connected with your child's participation in the Camp. 4) You agree that this Waiver, Release and Indemnification Agreement is to be construed under the laws of the State of Minnesota, U.S.A.; and that if any portion thereof is held invalid, the balance hereof shall, notwithstanding, continue in full legal force and effect. In signing this document, you hereby acknowledge that you have read this entire document, that you understand its terms, that you are the parent or legal guardian of the minor child(ren) listed in the registration and that by signing it you are giving up substantial legal rights you might otherwise have, and that you have signed it knowingly and voluntarily.
By checking this box you agree to this waiver:
BEHAVIOR POLICY:
Your child will be respectful of all individuals (other students and adults) while at Scrubs Camp. Your child will not use his/her cell phone during camp activities and sessions. If he/she is caught using the phone during an activity/session it will be taken away for the remainder of the day and returned after camp completion. Your child will be respectful of all public and private property, including Minnesota States residence halls and classroom spaces. Your child will not use alcoholic beverages, tobacco products, or illicit drugs of any kind while at Camp. Your child will not use drugs unless prescribed by a licensed physician, in which case a medication form needs to be filled out at check-in. Medications must be administered by Camp staff. Your child will keep his/her Camp counselor informed of their whereabouts and will not leave the College or University campus without the supervision of Camp staff. If your child drives themselves to Camp, they will be expected to turn in their car keys for the duration of camp for safety and liability reasons. Your child will wear their Scrubs Camp identification badge and/or their scrubs top at all times. Your child understands that they could be sent home if in violation of any of the rules above.
By checking this box you agree to this policy:
PHOTO WAIVER:
You understand that your child(ren)’s likeness/image may be used in the manner described in the description of this offering, and grant HealthforceMN (HFMN) the right to use and reuse, in any manner at all, the still photograph productions and/or publications as described in the description of this offering. You hereby forever release and discharge HFMN and their partners from any and all claims, actions and demands arising out of or in connection with the use of said still photograph, including without limitation, any and all claims for invasion of privacy and libel. This release shall insure to the benefits of the assigns, licensees and legal representatives of HFMN, as well as the party(ies) for whom the HFMN took the still photograph. You represent that you have read the foregoing and fully and completely understand the contents hereof.
By checking this box you agree to this waiver:
DATA RELEASE AUTHORIZATION
I authorize the release of my child’s information regarding their participation in or attendance at Scrubs Camp to be released to state education authorities and agencies, understanding that the information provided by Winona State University to these authorities and agencies will be used only to evaluate the effectiveness of program activities and fulfill program reporting requirements.
By checking this box I agree to this authorization:
TRANSCRIPT RELEASE AUTHORIZATION
I authorize the release of my child’s transcript to Winona State University and the Minnesota Office of Higher Education. I understand that my transcript will be used only to evaluate if my child’s GPA meets Office of Higher Education scholarship requirements.
By checking this box I agree to this authorization:
POLICY & WAIVER AGREEMENT ELECTRONIC SIGNATURE:
By signing this document electronically, you and your child agree to the behavior policy, liability waiver, cancellation/refund policy, photo waiver, data release authorization, and transcript release authorization.