RELEASE AND INDEMNIFICATION AGREEMENT
Saint Francis Day of Service - Sunday, September 29, 2024
Name:
*
First Name
Last Name
Student/Employee ID#:
*
RELEASE AND IDEMNIFICATION AGREEMENT
I, the above named Participant, or the parent and/or legal guardian of the Participant listed above, am at least eighteen years of age and am fully competent to sign this Agreement. I have voluntarily chosen to participate or to allow my child to participate in the above-referenced Activity. I acknowledge that the Participant’s involvement in this activity may expose the Participant to hazards or risks that may result in illness, personal injury or death and I understand and appreciate the nature of such hazards and risks. In consideration of my voluntary participation in the Activity, I hereby accept all risk to the Participant’s health and of their injury which may result from such participation and I hereby release Alvernia University, its governing board, officers, employees and representatives from any and all liability to me, my personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to my property and for any and all illness or injury to Participant, including death, that may result from or occur during participation in the Activity, whether caused by the negligence of Alvernia University, its governing board, officers, employees, or representatives, or otherwise. I further agree to indemnify and hold harmless Alvernia University and its governing board, officers, employees, and representatives from liability for the injury or death of any person(s) and damage to property that may result from the negligent or intentional acts or omissions of the Participant while participating in the described Activity.
Who to Contact in Case of Emergency:
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Mother
Father
Guardian
Other
Name of Emergency Contact:
*
Phone Number of Emergency Contact:
*
I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND IT TO BE A RELEASE OF ALL CLAIMS AND CAUSES OF ACTION FOR INJURY TO THEPARTICIPANT OR DAMAGE TO THEIR PROPERTY THAT OCCURS WHILE PARTICIPATING IN THEDESCRIBED ACTIVITY AND IT OBLIGATES ME TO INDEMNIFY THE PARTIES NAMED FOR ANYLIABILITY FOR INJURY OR DEATH TO ANY PERSON AND DAMAGE TO PROPERTY CAUSED BYTHE PARTICIPANT’S NEGLIGENT OR INTENTIONAL ACTS OR OMISSIONS.
Date Participant Signed:
Submit
Should be Empty: