Medical Release and Authorization

As a parent or court appointed legal guardian of {studentsName}, I hereby give permission for him to participate in The American Legion Illinois Premier Boys State; agree that any photographs or videos taken of my son in the course of his participation in Illinois Boys State may be used in the Illinois Boys State yearbook, newspaper, website or promotional material; authorize, in the event of his injury or sickness, such medical treatment or diagnostic procedures as may be deemed advisable, to be performed by EIU Health Center, Sara Bush Lincoln Health Center, or such health care provider as shall be designated by the President, Director of Counselors, Executive Director, or authorized staff member of American Legion Illinois Premier Boys State.

Waiver of Liability and Hold Harmless Agreement

This is a legally-binding Liability Release, Waiver, Discharge, and Covenant Not to Sue made by me, the above named student (hereinafter referred to as “Participant”) to THE BOARD OF TRUSTEES OF EASTERN ILLINOIS UNIVERSITY (hereinafter referred to as the "University").

Participant, as a visitor of Eastern Illinois University and the Office of Conference Services at Eastern Illinois University, acknowledges that neither the University, nor any of its employees, is responsible for any cost, damage to personal property, loss of property, bodily injury, sickness, or accidental death as a result of participation in or attendance at any conference or activity at Eastern Illinois University, while on university property, including travel to and from the area the activity is conducted. Participant agrees to indemnify and hold harmless the University, its employees, and any persons associated with the Office of Conference Services, and agrees to take full responsibility for all risks and liability associated with this conference or activity.

Participant understands that he/she must be accompanied by a staff chaperone in any residential, dining, athletic, or academic facility on the property of Eastern Illinois University. Participant has discussed all University policies with chaperones and staff involved with group and assumes complete risk of any activity done in violation of any policy or law during the duration of our conference or activity.

By signing, participant acknowledges that he/she has read and understands the foregoing Waiver of Liability and Hold Harmless Agreement. This waiver must be included with the registration form.

Confirmation

BY ACKNOWLEDGING AND SIGNING, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.