ASSUMPTION OF RISKS, RELEASE & INDEMNIFICATION FOR
PARTICIPATION IN THE INTERNATIONAL FRIENDSHIP PROGRAM
I, __________________________________________________ (PRINT NAME), have
carefully reviewed the information provided regarding Elizabethtown College's
International Friendship Program and I would like to participate in the Program during
the 2013-2014 school year. In consideration of Elizabethtown College permitting me to
participate in the International Friendship Program and related activities (hereafter
“Program and related activities”) during the 2013-2014 school year, I hereby agree to the
following terms and conditions for my participation:
I am an adult, 18 years of age or older.
I acknowledge that I am
participating in this Program and
related activities, and that my participation is not required as a part of any
course of study at or by any employment with Elizabethtown College.
I agree to
abide by the rules and regulations
imposed by Elizabethtown
College and its employees or agents, including but not limited to the
Student Code of Conduct.
I understand and acknowledge that this Program and related activities
entail various risks, including the risks associated with travel, and the risks
of injury to or loss of property, personal injury, and in the worst case,
death, whether from illness, accidents, terrorism, or other causes.
Knowing the material risks and appreciating and reasonably anticipating
that injuries and even death are possible,
I hereby expressly assume all
of the risks of injury or death
that could occur as a result of my
participation in this Program and related activities.
I understand and agree that I am responsible for arranging my own health,
accident and liability insurance.
I hereby authorize the employees and/or agents of Elizabethtown College,
at their sole discretion, to secure such medical advice and/or services as
may be deemed necessary for my health and safety, and I agree to accept
full financial responsibility for such advice or services.
I understand and agree that Elizabethtown College and any and all
Elizabethtown College employees and agents associated with this Program
and related activities have not made and cannot make, me, my family, or
my heirs and assigns any promises or guarantees with regard to any health
and safety risks that I may incur as a result of my participation in this
Program and related activities.
I understand that during this Program, I agree to abstain from the use of
alcohol or conscious-altering drugs, whether legally obtained or not,
immediately prior to and during the Program and related activities. I
understand that the use of any such drug or alcohol constitutes a violation
of Elizabethtown College policies, and may constitute, as well, violations
of state or federal law punishable by fines, imprisonment or both.
ASSUMPTION OF RISKS,
RELEASE AND INDEMNIFICATION
FOR MYSELF AND ALL THOSE WHO MAY CLAIM THROUGH
ME OR IN MY PLACE, AND IN EXCHANGE FOR AND IN
CONSIDERATION OF ELIZABETHTOWN COLLEGE
PERMITTING ME TO PARTICIPATE IN THIS PROGRAM AND
RELATED ACTIVITIES, INCLUDING BUT NOT LIMITED TO
TRAVEL, I HEREBY ASSUME ALL THE RISKS OF INJURY
ASSOCIATED WITH THIS PROGRAM AND RELATED
ACTIVITIES AND AGREE TO RELEASE, HOLD HARMLESS,
AND INDEMNIFY ELIZABETHTOWN COLLEGE, ITS
OFFICERS, AGENTS, AND EMPLOYEES FROM ANY AND ALL
LIABILITY, ACTIONS, CAUSES OF ACTION, NEGLIGENCE,
CLAIMS OR DEMANDS OF ANY NATURE WHATSOEVER
THAT MAY ARISE BY OR IN CONNECTION WITH MY
PARTICIPATION IN THIS PROGRAM AND RELATED
I also agree that this waiver shall be governed by Pennsylvania substantive
law and that any litigation related to the enforceability of this waiver will
be brought in the Commonwealth of Pennsylvania.
In signing this document I acknowledge that I am 18 years of age or older, that I have
had an opportunity to ask any questions I have about this document, that I have read
it, that I understand it, that I have signed it knowingly and voluntarily, and that I
accept and intend to be legally bound by its terms
Date: _____________________ Signed: _____________________________________
Name Printed ________________________________