Waiver of Liability, Release, and Indemnity Agreement
California Baptist University - College of Architecture, Visual Arts & Design
In consideration of permission to use the property, facilities, staff, equipment and services of CaliforniaBaptist University for the duration of the Event/ Activity, the undersigned, for ourselves, our heirs, personalrepresentatives or assigns, do hereby agree not to sue. The undersigned releases, waives, and dischargesliability from California Baptist University, its trustees, officers, agents, servants, and employees fromany and all claims including the negligence of California Baptist University resulting in personal injury,accidents or illnesses (including death), and property loss arising from, but not limited to, participation inactivities, and use of facilities, premises, or equipment.The undersigned hereby understands and gives permission for myself or my minor dependent ( each a"participant" and collectively "participants") to engage in the California Baptist University event statedabove. I recognize and understand that the participant will be engaging in activities which may causee~posure to some level of risk of injury and that the participant will be engaging at their own risk. Iagree to and hereby do release and hold harmless California Baptist University and its trustees, agents,officers, servants, and employees against from any and all claim actions, suits, procedures, costs, expenses,damages and liabilities, arising or may be brought by or on behalf of bodily or personal injuries, damagesto property and consequences thereof which may be sustained by the said participant arising out of or inconnection with the event. Furthermore, I agree to indemnify California Baptist University for anyloss or damage to the premises, facility, or equipment caused by the participant. Such indemnificationsshall include costs and expenses incurred by California Baptist University, including reasonable attorneys'fees and all cost of medical treatment (should it be needed by the participant). I also agree that the eventmay use images of the participant for publicity and advertising purposes.I have read this Waiver of Liability, Release, and Indemnity Agreement and fully understand its terms, andunderstand that I am giving up substantial rights, including my right to sue. The undersigned furtherexpressly agrees that this agreement is intended to be as broad and inclusive as is permitted by the law ofthe State of California. We also agree to abide by all policies developed by California Baptist Universityand directions given by its personnel.The health history is true and correct to the best of my knowledge and the person herein described haspermission to engage in all prescribed event activities. In the event I cannot be reached in an emergency, Ihereby give permission to the medical personnel selected by the event director to hospitalize, secure propertreatment for, and to order injection, anesthesia or surgery for the participant.
Participant’s Name:
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First Name
Last Name
Parent or Guardian’s Name:
First Name
Last Name
Participant’s (Guardian’s) Signature:
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Date
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Month
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Day
Year
Date
Emergency Contact Name:
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First Name
Last Name
Emergency Contact Phone Number:
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Please enter a valid phone number.
Important Medical information (Ie. allergies, current medications, applicable health history):
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Standard Release
California Baptist University - College of Architecture, Visual Arts & Design
By signing this Release, I agree to and understand the following:The photograph( s) or video or audio recording( s) or testimonial taken of me by agents,employees or representatives of California Baptist University (hereinafter called "theUniversity") shall be used in connection with the University's educational, advertising andpromotional materials whereby it may be viewed or used on or off campus.I understand that this right includes the right to combine my picture, voice and/or movingimage with others and the right to alter any of these for the purposes of publicizingUniversity programs and for any other lawful purpose. In addition, I waive any right tophotos or videos I submitted to CBU and to inspect or approve the finished product.I hereby hold harmless and release and forever discharge the University from all claims,demands and causes of action that I or any third party acting on my behalf or the behalf ofmy estate have by reason of this authorization.
Name:
*
First Name
Last Name
Email:
*
email@calbaptist.edu
Phone Number:
Please enter a valid phone number.
Please check:
CBU Student
CBU Staff Member
CBU Faculty Member
High School Student
Other
Student ID (if applicable):
By signing my name electronically, I am agreeing that my electronic signature is the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing.
Signature:
Date:
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Month
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Day
Year
Date
If the individual signing above is not yet eighteen ( 18) years old, there should be consentby a parent or guardian as follows:I hereby certify that I am the Parent or Guardian of the above individual, a minor, and that Ihave read and approved the above Release.
Parent or Guardian’s Name:
First Name
Last Name
Parent or Guardian’s Signature:
Date:
-
Month
-
Day
Year
Date
Parent or Guardian’s Phone Number:
Please enter a valid phone number.
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