Liability Waiver and Indemnification. In consideration of permission granted by the School District for Student to participate in the Activities, I do hereby waive, release, and forever discharge the School District, its board of education, officers, agents, employees, volunteers, coaches, sponsors, insurers, legal counsel, and representatives (the “Released Parties”) from any and all claims, including without limitation any and all demands, rights, lawsuits, actions, cross-claims, counterclaims, third-party actions, liens, damages, debts, obligations, exemplary damages, consequential damages, punitive damages, liabilities, losses, expenses, and causes of action (hereinafter, “Claims”) that I, my Student, or one of our heirs, executors, administrators, or assigns may have against the Released Parties for all damages whatsoever, including without limitation any and all bodily injuries or loss of property which result from Student’s participation in the Activities, whether such injuries are caused by my negligence or the negligence of one or more of the Released Parties. Further, and without affecting the release and waiver stated herein, I agree to hold harmless, defend, and indemnify the Released Parties against any and all Claims that arise out of, are related to, or are in connection with Student’s participation in the Activities. I also agree to pay for any costs, attorney fees, or awards that may result from resisting any complaint or lawsuit that my Student or I bring against one or more of the Released Parties for any injury or loss my Student or I claim to have suffered. Expectation to Comply with Instructions and Directives. I understand my Student is expected to follow all instructions given to him/her by the adults who will be supervising the summer conditioning, including but not limited to complying with all directives and guidelines suggested by the Centers for Disease Control and local health authorities. I have reviewed those guidelines with my son/daughter. I, the undersigned, and my Student have read this Acknowledgment, Waiver, and Release and understand all its terms. I, for myself and on behalf of my Student, execute it voluntarily and with full knowledge of its significance. I UNDERSTAND THAT IT CONTAINS A RELEASE OF LIABILITY, WAIVER, AND AN INDEMNIFICATION AND THAT I SHOULD READ IT CAREFULLY BEFORE SIGNING. I knowingly, voluntarily, and fully informed hereby give my permission for Student to participate in the Activities. STUDENT’S NAME: (“Student”) Parent’s Name: Parent...
Liability Waiver and Indemnification. Furthermore, in consideration of the opportunity afforded me, with full knowledge and appreciation of the risks involved, I hereby agree to indemnify, release and hold harmless; Stetson University, Inc., its faculty, staff, trustees, officers, representatives, agents, and host organizations from all form and manner of risks inherent or relating to such activities, and I waive all claims and demands of any nature arising from my volunteer participation, campus access and related travel. I agree and understand that this liability waiver and indemnification will extend beyond the dates of this agreement. I hereby acknowledge that I have had the opportunity to review this form and have it reviewed by legal counsel if necessary. I understand the foregoing and hereby agree to be bound by same. Signature of Volunteer: ___________________________________________________ Date: _____________ Print Full Legal Name of Volunteer _______________________________________________________________ Signature of Witness___________________________________ Printed Name: ________________________________ (Date) Volunteer Phone Contacts:_______________________________________________________________________ Address: __________________________________________________________________________________________ Email:______________________________________________________ Emergency Contact Info: __________________________________________________________________________________ Background Check Completed & Approved______ MVR Completed _____ (if applicable) Approved By: _______________________________________________________ Date:____________ Xxxxx Xxxxxxxx, Director of Human Resources / Stetson University (Rev. 7/13) AUTHORIZATION FOR RELEASE OF INFORMATION Stetson University, Inc. (“Stetson” or “the University”) is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, religion, national origin, handicap, or marital status. We assure you that your opportunity for employment, volunteer services or contract services with the University depends solely upon your qualifications. You are a candidate for employment, contracted, or voluntary services at Stetson University. As a standard procedure for all individuals applying for employment, contract or voluntary work that involves direct contact with students, the University conducts appropriate background screening, including a review of a candidate’s driving record (if driving as ...
Liability Waiver and Indemnification. Furthermore, in consideration of the observational experience afforded me, with full knowledge and appreciation of the risks involved, I hereby agree to indemnify, release and hold harmless Great River Health System, Inc., Southeast Iowa Regional Medical Center and its associated clinics, their respective staff, trustees, officers, representatives, and agents, from all form and manner of risks inherent or relating to such activities connected to my observational experience, and I waive all claims and demands of any nature arising from my observational experience. I agree and understand that this liability waiver and indemnification will extend beyond the dates of this agreement and observational experience.
Liability Waiver and Indemnification. The VOLUNTEER and any personal representative, on behalf of himself/herself and any dependents, holds harmless, releases and forever discharges SBFPS, their directors, employees, and volunteers, from any and all actions, causes of actions, including negligence, claims and demands for damages, loss or injury, resulting from or arising out of the VOLUNTEER’s involvement with SBFPS Liability Waiver and Indemnification (continued) The VOLUNTEER also indemnifies and holds harmless SBFPS from any and all claims, actions, causes of actions, demands, expenses or losses whatsoever which they may bear as a result of the VOLUNTEER’s involvement with SBFPS, by reason of damage to any and all property and any and all personal injuries, including death of others or the VOLUNTEER. The VOLUNTEER confirms that he/she is the full age of majority, or alternatively the VOLUNTEER has indicated that he/she is the guardian of the minor participant named, and that he/she has read and understands this agreement prior to signing it and agrees that this agreement will be binding upon him/her (as participants or guardians), his/her heirs, next of kin, executors, administrators and successors. Participant's/Guardian’s Signature In the presence of: Witness’ Signature Participant's/Guardian’s Printed Name Witness’ Printed Name
Liability Waiver and Indemnification. I , by signing below, hereby acknowledge that there is an inherent risk of injury when using outdoor facilities, such as City Parks, and factors outside of the City’s control, such as the weather, may increase the risk of injury. Therefore, I voluntarily release, to the full extent permitted by law, the City of Helena and its elected and appointed officials, officers, agents, employees, and volunteers, from any liability in connection with my use of the City’s facilities or equipment as specified in this application, including any claims which allege negligent acts or omissions on the part of the City. I understand that by signing this document, I may be waiving my legal rights to a jury trial to hold the City legally responsible for any injuries or damages resulting from risks inherent in sport and outdoor recreational opportunities or for any injuries or damages I may suffer due to the City’s ordinary negligence that are the result of the City’s failure to exercise reasonable care. I further agree to indemnify, defend, hold harmless, and save the City, its elected and appointed officials, officers, agents, employees, and volunteers from any and all claims, losses, damages, and liability, including the cost of defense thereof, occasioned by, growing out of, or in any way arising or resulting from my use of the City’s facilities or equipment or any act or omission on the part of myself, my agents, employees, officers, or invitees in connection with my use of the City’s facilities or equipment as specified in this application.
Liability Waiver and Indemnification. Renter has inspected or has had the opportunity to inspect the Facility and Renter has determined that the Facility is suitable and safe for the purpose for which it is being rented. Any guests of Renter during the Event are not invitees or guests of the City but are strictly invitees and guest of Renter for the benefit and purposes of Renter. Renter agrees to take all reasonable precautions for the safety of guests and other persons present at the Facility and shall provide all efforts to protect and prevent damage, injury, or loss to the Facility and to guests and other parties present for the Event. Xxxxxx releases, absolves, and exonerates; covenants not to sue; and agrees to indemnify and hol harmless to the City and all of its facilities and grounds, its directors, officers, agents, and employees against any and all liability, losses, claims, demands, actions, debts, expenses and causes of action of every name and nature for personal or bodily injury (including any resulting death) or other damages which may be sustained by any person, and for damage to or loss of any property, during, as a result of, incident to, or in any way arising out of the use of the Facility. Said indemnification shall include but not be limited to reasonable attorney’s fees and all court costs. This indemnification shall survive the cancellation of termination of this Agreement. The City is not responsible for any lost, damaged, or stolen property left before, during, or following the Event.
Liability Waiver and Indemnification. Furthermore, in consideration of the opportunity afforded me, with full knowledge and appreciation of the risks involved, I hereby agree to indemnify, release and hold harmless; University of RI, State of RI, RI Board of Education, their faculty, staff, trustees, officers, representatives, agents, and host organizations from all form and manner of risks inherent or relating to such activities, and I waive all claims and demands of any nature arising from my volunteer participation, campus access and related travel. I agree and understand that this liability waiver and indemnification will extend beyond the dates of this agreement. I hereby acknowledge that I have had the opportunity to review this form and have it reviewed by legal counsel if necessary. I understand the foregoing and hereby agree to be bound by same. Volunteer Name: Address: Email:
Liability Waiver and Indemnification. The VOLUNTEER and any personal representative, on behalf of himself/herself and any dependents, holds harmless, releases and forever discharges SBFPS, their directors, employees, and volunteers, from any and all actions, causes of actions, including negligence, claims and demands for damages, loss or injury, resulting from or arising out of the VOLUNTEER’s involvement with SBFPS
Liability Waiver and Indemnification. The VOLUNTEER and any personal representative, on behalf of himself/herself and any dependents, holds harmless, releases and forever discharges SBFPS, their directors, employees, and volunteers, from any and all actions, causes of actions, including negligence, claims and demands for damages, loss or injury, resulting from or arising out of the VOLUNTEER’s involvement with SBFPS. The VOLUNTEER also indemnifies and holds harmless SBFPS from any and all claims, actions, causes of actions, demands, expenses or losses whatsoever which they may bear as a result of the VOLUNTEER’s involvement with SBFPS, by reason of damage to any and all property and any and all personal injuries, including death of others or the VOLUNTEER. The VOLUNTEER confirms that he/she is the full age of majority, or alternatively the VOLUNTEER has indicated that he/she is the guardian of the minor participant named, and that he/she has read and understands this agreement prior to signing it and agrees that this agreement will be binding upon him/her (as participants or guardians), his/her heirs, next of kin, executors, administrators and successors. Participant's/Guardian’s Signature In the presence of: Witness’ Signature Participant's/Guardian’s Printed Name Witness’ Printed Name
Liability Waiver and Indemnification. Furthermore, in consideration of the observational experience afforded me, with full knowledge and appreciation of the risks involved, I hereby agree to indemnify, release and hold harmless Great River Health System, Inc., Great River Medical Center, Great River Physician Clinics, their respective staff, trustees, officers, representatives, and agents, from all form and manner of risks inherent or relating to such activities connected to my observational experience, and I waive all claims and demands of any nature arising from my observational experience. I agree and understand that this liability waiver and indemnification will extend beyond the dates of this agreement and observational experience. HIPAA and Confidentiality I have reviewed the Great River Health System orientation materials which cover among other topics patient confidentiality and the federal HIPAA requirements. I understand the content of those materials and have had an opportunity to ask questions about any of the material that I may not have understood. I hereby acknowledge that I have had the opportunity to review this form and have it reviewed by legal counsel if I deem necessary. I understand the foregoing and hereby agree to be bound by same. I agree to comply with Great River Health System and federal requirements relating to confidentiality of patient information and HIPAA. Signature of Student: __________________________________________ Date: ___________________________
