Liability Information. In consideration for myself and my minor children being permitted by the Knight Foundry Alliance and the City of Xxxxxx Creek (Owner) to participate in activities associated with the CBA blacksmithing workshops conducted by the Knight Foundry Alliance at the Historic Knight Foundry site located at 00 Xxxxxx Xxxxxx, Xxxxxx Xxxxx, California starting on January 1st, 2024 (hereinafter Activity or Activities), I hereby waive, release and discharge any and all claims and damages for personal injury, death or property damage which I or my minor children may sustain or which may occur as a result of mine or my minor children’s participation in these Activities.
Liability Information. Do you have professional liability coverage? Yes [ ] No [ ] Name of Carrier Policy Coverage Limits: per Occurrence Aggregate Expiration Date: Have you changed your professional liability carrier within the past ten years? Yes [ ] No [ ] If yes, please list your previous carrier(s), period(s) of coverage and policy number(s) on a separate sheet. Do you have any general liability coverage? [ ] Yes [ ] No Name of Carrier $ Coverage Limits • Are you presently involved in any malpractice suit(s)? Yes [ ] No [ ] • Have you ever previously been involved in a malpractice suit? Yes [ ] No [ ] • Has any payment been made by you, or on your behalf, as a result of a malpractice claim settlement not involving litigation, a settlement that occurred prior to a judgment involving litigation, or a settlement that was the result of a judgment involving litigation? Yes [ ] No [ ] If you answered yes to any of the above questions, please complete the following medical malpractice history form for each case in which you were involved within the past ten years which includes both new and resolved cases. If you answered yes to any of the above questions but have not been involved in any pending or settled claims within the past 10 years, so state. Please complete this section if you reported any malpractice actions on your application. If additional sheets are required, please photocopy this page prior to completion. A separate sheet should be used for each malpractice action. Name of Patient Your relationship to patient: [ ] Attending Dentist [ ] Attending Oral Surgeon [ ] Assistant Oral Surgeon [ ] Consultant [ ] Other Location of Incident: _ Date Reported: Insurance Carrier: Additional Defendants: Check appropriate box: [ ] Open [ ] Closed If closed, indicate method of closing: [ ] Dismissal [ ] Dropped [ ] Settled [ ] Judgment Amount of Settlement or Judgment: Date of Payment: - Please describe the care your rendered and treatment prescribed for the patient. Condition and diagnosis at time of incident: Dates and description of treatment rendered: Condition of patient subsequent to treatment: • Has your license to practice dentistry in any state ever been revoked, restricted, suspended, voluntarily surrendered in lieu of pending adverse action, or been made subject to probationary terms, reprimand, censure, supervision or fine? • Has your license to dispense or prescribe any narcotic ever been denied, revoked, restricted, suspended, voluntarily surrendered in lieu of pe...
Liability Information. LESSEE agrees that it alone shall be liable for all damages to the premises, equipment and/or other items supplied to or for the LESSEE and/or injuries to persons attending the specified event and/or using rented equipment and/or other items supplied to or for the LESSEE by LESSOR. The LESSEE expressly waives all causes of action it may have against the LESSOR, its’ agents and employees as a result of the
Liability Information. Advisers, provided they are State employees, enjoy the liability protection under the Tort-Claims Act. This means that they are covered for acts and omissions while in the course and scope of their duties as an organization adviser. This means that they have professional liability insurance, but not necessarily personal liability insurance. Not everything is covered, even if you write it down. The only thing that is inherently obvious is that an adviser advises. Everything else is subjective. Student Involvement: • Assists students in gaining more knowledge about their field of study or fields of interest. • Helps to establish new friendships and a diverse network that will be there for you in business and in life. • Develops a broad range of marketable and transferrable skills in areas such as leadership, communication, organization, critical thinking • Provides assistance to our community through service projects. • Creates a fun, safe social environment in an academic setting. Every student organization must have a campus adviser which shall be defined as an exempt faculty, staff, or administrative officer of the University who shall offer support and advice to the organization. Any exceptions to employment status are at the discretion of the Office of Student Life and Engagement under the advisement of the Division of Student Affairs. The amount of involvement expected of the adviser will depend primarily on the level of activity of the organization. An individual should not accept the invitation to serve as an adviser if not prepared to fulfill the expectations of the role. The adviser should understand that the role of organization advisement is service provided as a volunteer, and should not interfere with normal job duties. The adviser is aware that compensation is not provided for advisement. The voluntary association between the adviser and the organization should continue as long as both parties believe the relationship is productive and mutually satisfactory. The adviser should outline and discuss your role as adviser and your expectations with the executive officers of the student organization and ensure both are in agreement that your advisement is needed, required, and beneficial to the existence of the organization. The adviser should seek to ensure the best interest of the university and its students are not at risk. If at any time you question the student organization’s recognition of the policies and procedures in the student handbook, s...
Liability Information. Education Minnesota membership provides $1 million dollars of liability coverage per individual per incident. In the event there is an injury to a student, teacher should follow the procedure established in school and district policy. However, here are guidelines to follow in case of injury: Notify another staff member. Do not administer First Aid unless you are certified to do so. Maintain environment and emotional control of the classroom. After things quiet down - immediately take the necessary steps to correct the cause of injury. Report the incident to administration. Call your Building Representative, President and Field Staff at your earliest convenience. Document everything that happened in detail (date, time, etc.). Keep a record for your file and send one copy to the President and Field Staff. Anticipate legal action: State on paper a chronological order of the events with your observations and perceptions. Identify witnesses and get statements. Do not talk to any representative of parents alone, nor sign any statements without contacting your Field Staff. Keep all your records until the injured party reaches the age of majority. Subdivision 19 of Minnesota Statute 122A.40 is about the records that are kept on individual teachers. Under this statute, members have the right to view and copy any and all private personnel files that the district or district administrators maintain on them. It is recommended that members review their personnel file at least once per year. To review the file, members should send a written request to the district superintendent (Xxxxx Xxxxxxxx) or the secretary for the superintendent (Xxxxx Xxxxxxxxx). The statute requires that the request be met “immediately (within 10 days). Whenever a member reviews his/her file, he/she should take along a witness. The following process should be followed: Go through the file and number sequentially each document in the file. Make a list of each document by number (including number of pages) and an easily identifiable description. Initial and date the document by the number that was placed on the document. If possible, the witness should also do #3. On the separate list of documents, the witness should sign and date. Request any documents as needed. DO NOT REMOVE OR ADD MATERIALS TO YOUR FILE DURING THIS REVIEW. Contact your building representative, President or Education Minnesota field staff. Unless it has been disclosed to you, it cannot be used against you (unless it’s apart of ...
