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Publish Date: October 26, 2022

Additional Terms and Conditions For Participants Attending

STANFORD UNIVERSITY:

Assumption of Risk, Release of Claims, Indemnification, and Hold Harmless Agreement

The parties to this Agreement are the student attending an iD Tech Program at Stanford University (Participant), Participant's parents or legal guardian, if Participant is under 18, (all referred to hereafter jointly and severally as "Participant") and the Board of Trustees of the Leland Stanford Junior University its officers, trustees, faculty, agents, representatives, volunteers, students, and employees ("Stanford”) for iD Tech Programs held at Stanford University  (“Event”) (“Stanford” and “Event” are collectively referred to hereafter as “Released Parties”).

Participant is a voluntary participant in this Event. Participant understands and agrees that Participant voluntarily assumes any and all risks in any way related to their participation in the Program. Participant is a voluntary participant in this Program. Participant understands and agrees that the Program and any related activities may be dangerous, may involve travel off the Stanford campus, either within or outside of the United States, and that neither the Program nor Stanford can guarantee the Participant’s safety. Any activities in which Participant may take part, whether as a component of the Program or separate from it, have been undertaken with Participant's understanding and assumption of any and all risks involved. The specific risks vary from one Program to another, but they may range from minor injuries (e.g., cuts, bruises or sprains) to catastrophic injuries (e.g., paralysis and death). Participant understands that injuries or outcomes may arise from their own or others’ actions, inaction, or negligence; conditions related to any travel or other aspects of participation in the Program; or the condition of the location or premises where the Program is taking place.

Participant understands they may face unique risks when the Program involves travel, and acknowledges that it is Participant’s responsibility to take every precaution to safeguard Participant’s health, safety and security, and the safety and security of their personal belongings and premises.

If any travel is outside of the United States, Participant acknowledges that they have reviewed and understand the advisories for the locations Participant will visit, posted by the United States Department of State, by the United States Centers for Disease Control, and by International SOS posted at https://www.internationalsos.com/member-zone using Stanford membership number 11BCPA000272. In addition, the Participant acknowledges that they have reviewed and understood the general advice and precautions for overseas travel posted by the U.S. Department of Justice. Nonetheless, Participant assumes all related risks whether or not listed above, in relation to their participation in the Program, including travel to, from and during the Program. Physical Condition and Insurance. Participant attests that Participant is physically and mentally capable of participating in the Program and has no known health or other restrictions that might jeopardize Participant’s safety or health or the safety or health of others during their participation in the Program. Participant gives permission for Stanford or its representative to provide immediate and reasonable emergency care should it be required. If Stanford learns that Participant is experiencing serious health problems or has suffered an injury, or is otherwise in a situation that raises significant health and safety concerns, Stanford may contact Participant’s emergency contact and share Participant’s personal information and documents (including health information) with third parties in furtherance of protecting Participant’s health, safety, or security.

Participant agrees to be solely responsible for payment in full of all costs of medical or emergency care they may receive, including without limitation emergency evacuation services.

Photo/Video Release. Participant agrees that Stanford may record, edit, use, reproduce, publish, and distribute by way of any and all media and transmission, the visual and/or audio likeness of Participant and other commentaries, information, and materials the Participant may provide in connection with the Program, which includes, without limitation, Participant’s name, biographical information, recorded voice, likeness, commentaries, presentation materials, and/or performance at the Program. Stanford is further granted permission to use such materials for educational, fund-raising, promotional, or other purposes worldwide and in perpetuity, to the extent permitted by applicable law.

Waiver and Release of Claims. In consideration of being accepted into and/or participating in the Program, Participant agrees to and hereby does, for Participant and on behalf of Participant’s heirs, executors, administrators, employers, agents, representatives, insurers, and attorneys, release and discharge Stanford of and from any and all claims which may arise from any cause whatsoever, including claims arising from any negligent act or omission by Stanford in any way related to participation in the Program. Participant further releases and discharges Stanford from liability for any accident, illness, injury, loss or damage to personal property, or any other consequences or claims or expenses of any kind whatsoever, arising or resulting directly, indirectly or incidentally from Participant's participation in the Program or in any way related thereto.

Indemnification and Hold Harmless. Participant hereby agrees to indemnify, defend, and hold harmless Stanford from any and all claims of injury, loss, damages, or liability whatsoever including reasonable attorneys' fees and/or any other associated costs, that may arise as a result of Participant’s participation in the Program. If Stanford incurs any of these types of expenses, Participant agrees to reimburse Stanford. To the extent Participant chooses to enter or remain in a location before or after participation in the Program, engages in activities that are not part of the Program, or chooses voluntarily to end participation in the Program, Participant recognizes and agrees that Stanford shall not be acting as their sponsor. If and to the extent Participant may cause or sustain personal injury or other damage to themselves or others, or damage or loss to their own or others’ property, Participant understands that Stanford will not be held responsible regardless of cause or fault.

Adherence to Standards. Participant understands and agrees to abide by all Stanford policies, rules, and regulations applicable to the Program, including without limitation Stanford’s international travel policy located at https://provost.stanford.edu/2017/03/03/international-travel-policy-2/.

Participant understands and agrees to abide by applicable laws, rules, regulations, and public orders of the country, state or province, including the Centers for Disease Control and Prevention, and by all Stanford guidance and policies, rules, and regulations applicable to the Program, including without limitation Stanford’s policies in the context of the Covid-19 pandemic located at: https://healthalerts.stanford.edu/. When traveling outside the United States, Participant is solely responsible for evaluating, understanding, and complying with visa and entry requirements, including COVID entry requirements, and local laws of the destination location(s).

Termination of Participation. Participant understands that, in its sole discretion, Stanford or its representative may terminate, without notice or cause, Participant’s participation at any time, including during the Program. Such termination shall not diminish or otherwise alter Participant’s obligation to make any payment required for the Program, nor shall Stanford be required to make any refund for personal expenses incurred by the Participant.

Program Modification and Cancellation. Stanford reserves the right to cancel or modify the Program before or during its operation for any reason Governing Law and Venue. This Agreement shall be construed in accordance with, and governed by, the laws of the State of California. The parties agree to submit to jurisdiction and venue in the State Courts of Santa Clara County, California.

Construction and Scope of Agreement. This Agreement is the only, sole, entire, and complete agreement of the parties relating in any way to the subject matter hereof. No statements, promises, or representations have been made by any party to any other, or relied upon, and no consideration has been offered or promised, other than as may be expressly provided herein. This Assumption of Risk, Release of Claims, Indemnification, and Hold Harmless and Agreement supersedes any earlier written or oral understandings or agreements between the parties. If any provision of this Agreement is held invalid, the invalidity shall not affect its other provisions.

Participant acknowledges that they have read this Assumption of Risk, Release of Claims and Hold Harmless Agreement, understands its meaning and effect, and agrees to be bound by its terms.

Additional Terms and Conditions For Participants Attending

WASHINGTON UNIVERSITY IN ST. LOUIS

Parent/Guardian Approval for Participation

I hereby certify and agree that my child/student has my approval to participate in the iD Tech program (hereinafter "the Activity") to be held at Washington University in St. Louis.

I know the nature of the Activity and My Child's experience and capabilities and consider My Child to be qualified to participate in the Activity. However, I acknowledge that there are certain risks of physical injury or illness associated with the Activity.

In return for My Child's participation in the Activity: I fully and forever RELEASE, WAIVE, DISCHARGE, ACQUIT, INDEMNIFY, HOLD HARMLESS and COVENANT NOT TO SUE, Washington University in St. Louis, including its governing board, officers, employees, students, agents, and volunteers (hereinafter collectively referred to as "Releasees") from any and all liabilities, claims, or injuries, including death, that may be sustained while participating in this activity, including but not limited to travel to, from, and for the activity, or while on premises owned or controlled by Releasees. I understand this release does not apply to injuries caused by intentional or grossly negligent conduct on the part of the Releasees. I further agree to indemnify and hold harmless Releasees for any loss, liability, claim or injury caused by me (my child) while participating in this activity including traveling to, from, and for the activity, or while on premises owned or controlled by Releasees.

I recognize that the Releasees do not assume responsibility for or liability for – including costs and attorney’s fees – any accident or injury or damage resulting from any aspect of participation in the Activity. The Releasees are not liable for any special, incidental, or consequential damages arising out of or in connection with any aspect of participation in the Activity.

I also give permission for My Child to receive any emergency medical treatment by a healthcare professional, including emergency medical transportation, which may be required for injuries sustained by My Child. However, I agree that the Releasees (including, but not limited to, each of the Releasees' regents, boards, agents, employees, officers, or representatives) are not responsible for any medical bill incurred as a result of any personal illness or injury to My Child, even if a Releasee has signed hospital documentation promising to pay for the treatment. That medical bill is my responsibility.

I understand that agreeing to this document, I give up substantial rights that I or My Child would have otherwise to receive damages for any loss occasioned by Releasees' fault, and I agree to it voluntarily and without inducement.

Important Note to Participants and Custodial Parents and Legal Guardians. By agreeing to these Terms and Conditions, you confirm that you understand and agree to the full content of the above waiver as documented by the university. The effective date and time of this agreement is equivalent to the date and time you agree to these Terms and Conditions.

THIS IS A WAIVER OF LEGAL RIGHTS. READ AND UNDERSTAND BEFORE REGISTERING.

Additional Terms and Conditions For Participants Attending

VANDERBILT UNIVERSITY:

Parent/Guardian Approval for Participation

I hereby certify and agree that my child/student has my approval to participate in the iD Tech program (hereinafter "the Activity") to be held at Vanderbilt University in Nashville.

I know the nature of the Activity and My Child's experience and capabilities and consider My Child to be qualified to participate in the Activity. However, I acknowledge that there are certain risks of physical injury or illness associated with the Activity.

In return for My Child's participation in the Activity: I fully and forever RELEASE, WAIVE, DISCHARGE, ACQUIT, INDEMNIFY, HOLD HARMLESS, and COVENANT NOT TO SUE, Vanderbilt University in Nashville, including its governing board, officers, employees, students, agents and volunteers (hereinafter collectively referred to as "Releasees") from any and all liabilities, claims, or injuries, including death, that may be sustained while participating in this activity, including but not limited to travel to, from, and for the activity, or while on premises owned or controlled by Releasees. I understand this release does not apply to injuries caused by intentional or grossly negligent conduct on the part of the Releasees. I further agree to indemnify and hold harmless Releasees for any loss, liability, claim, or injury caused by me (My Child) while participating in this activity including traveling to, from, and for the activity, or while on premises owned or controlled by Releasees.

I recognize that the Releasees do not assume responsibility for or liability for – including costs and attorneys’ fees – any accident or injury or damage resulting from any aspect of participation in the Activity. The Releasees are not liable for any special, incidental, or consequential damages arising out of or in connection with any aspect of participation in the Activity.

I also give permission for My Child to receive any emergency medical treatment by a healthcare professional, including emergency medical transportation, which may be required for injuries sustained by My Child. However, I agree that the Releasees (including, but not limited to, each of the Releasees' regents, boards, agents, employees, officers, or representatives) are not responsible for any medical bill incurred as a result of any personal illness or injury to My Child, even if a Releasee has signed hospital documentation promising to pay for the treatment. That medical bill is my responsibility.

I understand that agreeing to this document, I give up substantial rights that I or My Child would have otherwise to receive damages for any loss occasioned by Releasees' fault, and I agree to it voluntarily and without inducement.

Important Note to Participants and Custodial Parents and Legal Guardians. By agreeing to these Terms and Conditions, you confirm that you understand and agree to the full content of the above waiver as documented by the university. The effective date and time of this agreement is equivalent to the date and time you agree to these Terms and Conditions.

THIS IS A WAIVER OF LEGAL RIGHTS. READ AND UNDERSTAND BEFORE REGISTERING.

Additional Terms and Conditions For Participants Attending

UNIVERSITY OF MICHIGAN:

Summer Program Permission Slip / Rules & Regulations

Residence hall rules and regulations with regard to student conduct and the use of facilities are established in compliance with state and federal laws and the University of Michigan Regents’ by-laws. Program registration is predicated upon the understanding and compliance with these rules and regulations. All program participants, students, must abide by our rules and regulations regardless of age. This includes counselors, organizers, and any program personnel residing and visiting in the residence halls. The cooperation of everyone is required if summer programs are to be successful and rewarding for all participants. More information regarding housing at the university can be found at http://housing.umich.edu/conferences/summer-programs.

Important Note to Participants and Custodial Parents and Legal Guardians. By agreeing to these Terms and Conditions, you confirm that you understand and agree to abide by the full content of the Rules and Regulations as documented by the university. You understand that failure to abide by these rules and regulations may result in various forms of discipline, up to and including immediate dismissal from the program. The effective date and time of this agreement is equivalent to the date and time you agree to these Terms and Conditions.

Thank you for your cooperation.

University of Michigan

PLEASE READ BELOW:

RESIDENCE HALL RULES AND REGULATIONS

CONDUCT

Acts of discrimination or discriminatory harassment based upon an individual’s race, sex, color, religion, creed, national origin or ancestry, age, marital status, handicap, Vietnam-era status, or sexual orientation are a serious violation of University policy and will be dealt with promptly. Sexual harassment is illegal under both state and federal law. In some cases, it may be susceptible to prosecution under the criminal sexual conduct law.

Alcoholic beverages, illegal drugs, laser pens, fireworks, explosives, and all weapons are absolutely prohibited in the hall. It is against the law to tamper or misuse building fire alarms or fire-fighting equipment. Tampering with or misuse of elevator alarms, emergency call buttons or calling 911 from a room or elevator telephone, except in an emergency, is against the law. Penalties will be enforced.

Each room will be inspected prior to arrival and before departure and any damages to the room or to University property will be assessed and charged to the program, which may then be assessed to the participant. The room must be left in the same condition as it was during move in. Do not fasten anything to the walls or tamper with window screens. Excessive mess resulting in extra housekeeping hours will result in a charge to the program and may be passed on to the student.

Appropriate behavior is expected at all times. Engaging in sexual contact with another student is a violation of our conduct policy. Leaving the program or residence hall without permission and appropriate supervision is a violation of our conduct policy. Bullying, taunting, or threatening behavior toward other students is a violation of our conduct policy. Excessive noise or rowdiness will not be tolerated. Dangerous behavior, including fighting, is a violation and will not be tolerated. Throwing items out of residence hall windows is a conduct violation.

The use of candles, open flames, explosives, smoke bombs, “snaps,” or fireworks is dangerous and will not be tolerated in the residence halls or at any U-M facility.

WE ARE A SMOKE FREE CAMPUS. SMOKING ON CAMPUS OR IN OUR BUILDINGS IS PROHIBITED.

AGE ELIGIBILITY

All students residing in a University of Michigan residence hall must be ten (10) years of age on or before the start of their program. There are no exceptions to this policy.

MEDICATIONS

All medications prescribed by a doctor must be dispensed by program nurses or counselors. Please fill out the medical forms and bring medications to the attention of the program staff at registration. Housing staff are not authorized to dispense medications.

VISITORS

ALL VISITORS, INCLUDING PARENTS MUST CHECK-IN FIRST WITH THE FRONT DESK WHEN VISITING A STUDENT. Only students and program staff are allowed in the living areas of the building. At no time are students permitted in the living areas to which they are not assigned. Students may only be checked out of the residence hall by a parent/guardian or program staff. Visitors, other than parents, who may be taking the student from the residence hall, must be approved by the parent/guardian during registration.

KEYS AND STUDENT IDENTIFICATION

Students are identified in a variety of ways including room keys and lanyards. Some programs may use wristbands. Any identification specific to the program will be issued along with a room keycard and lanyard at check-in. If the identification is lost, a replacement may be obtained at the front desk or from a staff member. The room keycard and identification should not be loaned to anyone and are not transferable.

MEAL TIMES

You may eat at any time during the hours your program has designated for meals. Students may be asked to show program identification at mealtime. In the case of lost identification, help is always available from dining and program staff. Meal hours will be provided by your program staff and are available from residence hall staff as well. Students are expected to eat meals in their assigned dining facility during their designated meal times. Food allergies should be reported to the program and dining staff prior to the student’s arrival.

MOTOR VEHICLES

Students are not to bring private automobiles or motorcycles to the University. If it is necessary for a student to drive, please discuss permission and parking with the program organizers. The vehicle must be registered and the keys turned in to the program organizers/counselors during the entire program. The University assumes no responsibility for a stored vehicle on University property.

PERSONAL PROPERTY

The University assumes no responsibility for personal property. Please leave valuable electronic items at home. Bring only a small amount of personal expense money with you since the halls do not have any secured storage facilities. You may wish to consult with your insurance company regarding coverage of your personal property while away at the program.

FOR SECURITY, ROOM DOORS ARE TO BE LOCKED AT ALL TIMES.

DAMAGES

Room checks will be conducted by program staff to determine room damages. Any damages caused in the rooms or common areas will be charged to the program. The program may decide to pass along damage expenses to the student.

MAIL

Mail will be distributed to program counselor to give to students. Mail should be addressed as follows:

Student’s Name

Name of the Program

West Quad Residence Hall

541 Thompson Street

Ann Arbor, MI 48109-2025

LINENS & ITEMS TO BRING

Students are responsible for bringing their own pillow, XL twin bed sheets or sleeping bag, blanket, towels, and toiletries.

Other recommended items include an alarm clock, a fan and sunblock. Students may bring water or beverages to keep in their rooms. Refrigerators are not available through the Residence Hall.

EARLY DEPARTURES

If a student must leave before the official ending date for the program, a parent or guardian must notify the program organizers and fill out any necessary forms with the program. If the student is being picked up by someone other than the person designated parent/guardian, written permission naming the responsible adult must be placed on the back of the registration card, during registration, prior to the student being released. A signed Early Release form from the program organizer must be turned in upon checking out from the resident hall. Identification is required.

PENALTIES

VIOLATION OF THESE RULES AND REGULATIONS MAY RESULT IN DISCIPLINE, UP TO AND INCLUDING IMMEDIATE DISMISSAL FROM THE PROGRAM AND SUBSEQUENT U-M PROGRAMS.

Students are reminded about proper behavior upon their arrival. Inappropriate behavior will be pointed out and verbal warnings will be given to students by organizers and counselors to correct the behavior. Students who endanger themselves or others, or who continue to commit violations after having been warned, will be sent home. The parent/guardian will be notified and asked to pick up the student immediately.

Additional Terms and Conditions For Participants Attending

THE UNIVERSITY OF TEXAS AT DALLAS

Participant Release and Indemnification Agreement

By agreeing to these terms and conditions I give permission for my child to participate in iD Tech’s camps/academies. I acknowledge that the nature of the camp/conference could possibly expose my child to hazards or risks that could result in illness, personal injury, or death, and I understand and appreciate the nature of such hazards and risks. In consideration of my child being permitted to participate in the camp/conference, I hereby accept all risk to my child’s health and of his/her injury or death that may result from such participation.

I hereby release UT Dallas and its governing board, officers, employees and representatives, in their individual and official capacities, from any liability to my child and their personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to my child’s property and for any and all illness or injury to my child, including his/her death, that may result from or occur during their participation in the camp/conference, WHETHER CAUSED BY NEGLIGENCE OF THE INSTITUTION, ITS GOVERNING BOARD, OFFICERS, EMPLOYEES, OR REPRESENTATIVES, OR OTHERWISE.

I further agree to indemnify and hold harmless UT Dallas and its governing board, officers, employees, and representatives, in their individual and official capacities, from liability for the injury or death of any person(s) and damage to property that may result from my child's negligent or intentional act or omission while participating in the described camp/academy.

I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND IT TO BE A RELEASE OF ALL CLAIMS AND CAUSES OF ACTION FOR MY CHILD’S INJURY OR DEATH OR DAMAGE TO THEIR PROPERTY THAT OCCURS WHILE PARTICIPATING IN THE DESCRIBED CAMP/CONFERENCE, AND IT OBLIGATES ME TO INDEMNIFY THE PARTIES NAMED FOR ANY LIABILITY FOR INJURY OR DEATH OF ANY PERSON AND DAMAGE TO PROPERTY CAUSED BY MY CHILD’S NEGLIGENT OR INTENTIONAL ACT OR OMISSION.

Additional Terms and Conditions For Participants Attending

CALIFORNIA INSTITUTE OF TECHNOLOGY

Authorization and Release

I HAVE CAREFULLY READ THIS AUTHORIZATION AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, AN ASSUMPTION OF RISK, A PROMISE NOT TO SUE OR MAKE CLAIM, AND A PHOTO, VIDEO AND AUDIO RELEASE, AND I ACCEPT THIS OF MY OWN FREE WILL.

Important Note to Participants and Custodial Parents and Legal Guardians. By agreeing to these Terms and Conditions, you confirm that you understand and agree to the full content of the above waiver as documented by the university. The effective date and time of this agreement is equivalent to the date and time you agree to these Terms and Conditions.

Additional Terms and Conditions For Participants Attending

NORTHWESTERN UNIVERSITY

iD Tech LIABILITY WAIVER AND RELEASE

Please read this form carefully and be aware that in seeking permission from Northwestern University for your child to participate in a Northwestern University event, you will be waiving all claims for injuries you might sustain arising out of your participation. Participation in this event is voluntary and at your own discretion and judgment.

As a participant in the iD Tech Summer Camp for the summer of 2022, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, damages, or loss that I may sustain. Such risks inherent to this event may include: bodily injury.

I do hereby fully release and discharge Northwestern University, its trustees, officers, agents, and employees from any and all claims from injuries, damages, or loss that may accrue to me on account of my participation in the iD Tech Summer Camp.

I further agree to indemnify and hold harmless and defend Northwestern University, its officers, agents and employees from injuries, damages, and loss sustained by me and arising out of, connected with, or in any way associated with my participation in the iD Tech Summer Camp.

I have fully read and understand the foregoing. It is my express intent that this agreement shall bind the members of my family, my heirs and assigns. This agreement shall be construed in accordance with the laws of the State of Illinois.

Additional Terms and Conditions For Participants Attending

FAIRLEIGH DICKINSON UNIVERSITY

Release, Indemnification, and Hold Harmless Agreement

In consideration for the Attendee being permitted to participate in the iD Tech Program (“Activity”), I do waive and release forever any and all rights for claims and damages I may have against Fairleigh Dickinson University, its trustees, officers, agents, and employees, from and against any and all liability for any harm, injury damage, claims demands, actions, costs, and expenses of any nature which Attendee, whether caused by negligence or carelessness on the part of the Fairleigh Dickinson University, it officers, agents, and employees, or otherwise, while Attendee is in, on, upon, or in transit to or from the premises where the Activity, or any adjunct to the Activity, occurs or is being conducted.

I accept, understand and assume that there is a risk of injury in this Activity, due to the physical nature of the Activity, including but not limited to falls, contact with other participants, and being injured by equipment used in the camp. Attendee agrees to follow all instructions and to wear all necessary, recommended, and appropriate protective gear and equipment.

I understand that this Activity is neither administered nor sponsored by Fairleigh Dickinson University and that iD Tech is providing this instruction or camp outside the scope of his/her employment with Fairleigh Dickinson University. I agree to release, hold harmless, and indemnify Fairleigh Dickinson University, its trustees, officers, agents, and employees from any and all claims and liability arising out of the Activity.

I acknowledge that the foregoing release may include any Camp employee(s) that may also be employees of the University, but the release is not intended to waive any rights I may have against the Camp, or any Camp employee in their role as Camp employee.

Additional Terms and Conditions For Participants Attending

MASSACHUSETTS INSTITUTE OF TECHNOLOGY (MIT)

I acknowledge that I have read the MITnet Rules of Use (https://ist.mit.edu/network/rules) and understand my obligations as a user of MIT computer services and technology, as a participant in iD Tech Programs. Additionally, I agree to use the MIT computers and the Internet in accordance with applicable laws, with Institute standards of honesty and personal conduct, and in ways that are responsible, mature, and ethical.

Additional Terms and Conditions For Participants Attending

Southern New Hampshire University

Minor Participant Waiver Form

Waiver/Release Information

I understand that participation by my child in the Southern New Hampshire University program named above involves a certain degree of risk. I also understand that participation in the Program is entirely voluntary and requires participants to abide by applicable rules and standards of conduct.

In case of an emergency involving my child, I understand that effort will be made to contact me or the individual listed as the emergency contact person. In the event that neither I nor the emergency contact person can be reached, permission is hereby given to the medical provider selected by those in charge of the Program to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose protected health information to the supervisors of the Program, and/or any physician or health care provider involved in providing medical care to my child, including examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the me, and/or determination of my child’s ability to continue in the Program activities. I have carefully considered the risk involved and give consent for my child to participate in these activities. I approve the sharing of the information on this form with program administrators and professionals who need to know of medical situations that might require special consideration for the safety of my child.

In consideration for the permission granted by Southern New Hampshire for my child to participate in this Event, on my behalf and on behalf of the child, and each of my and the child’s heirs, executors, and administrators, I hereby waive and release any and all causes of action, claims, suits, damages, and judgments, in any form whatsoever, arising from or by reason of any and all known or unknown, foreseen or unforeseen bodily or personal injuries (including death) or property damage, resulting from the child’s participation in the Event and related activities, against Southern New Hampshire University and their employees, administrators, trustees, volunteers, and agents.

IN WITNESS WHEREOF, and intending to be legally bound, I agree to the terms above.

Additional Terms and Conditions For Participants Attending

The University of Alabama at Birmingham

Youth Protection Program: Liability Waiver

Purpose

These terms are to be accepted by each Participant (or the parent/guardian of any Participant under the age of 19) involved in the Program. In consideration for the educational, social, recreational, and other benefits to be provided, the receipt and adequacy of which is acknowledged, Participant agrees as follows.

Liability Release

THIS IS A RELEASE OF LIABILITY. Participant knowingly and voluntarily waives, releases, exculpates, and discharges UAB and any related third party entities or contractors from and against any and all Potential Liabilities connected with the Program. By agreeing to these terms, the Participant voluntarily agrees to discharge UAB and any related third party entities or contractors in advance from all such Potential Liabilities.

Indemnification

The Participant agrees to hold harmless and indemnify UAB from and against Potential Liabilities related to or arising from Participant’s involvement in the Program.

Assumption of Risk

The Participant understands and acknowledges that there are risks, including significant risks, inherent in all activities that can result in loss, damages, injury, or death, including, without limitation:

Health Care and Emergencies

UAB does not accept responsibility or liability for providing health care services or health care insurance for Participant. Participant should consult their own medical care provider and warrant their physical fitness to participate in the Program. Participant authorizes UAB to obtain any necessary medical treatment for Participant during the Program. Participant agrees to be responsible for the payment of any fees and charges that may be imposed by any doctor or hospital facility in the provision of medical care to Participant. Further, Participant agrees to indemnify and hold UAB harmless from any claim that may be made by a doctor of medical facility of said fees and charges incurred in the provision of medical care to Participant. The

Participant is required to provide the name(s) and contact number(s) for a parent, guardian, or other party that is a reliable contact in the event of emergencies.

Conduct

Participant agrees, for the duration of the Program, to abide by all applicable federal, state, and local laws as well as the rules and regulations for the Program. Participant also agrees to follow posted signs as well as instructions and directions of University officials and Program directors and supervisory staff.

Photography

Participant acknowledges that photographs and possible videos may be taken and irrevocably and perpetually authorizes UAB to broadcast these images. Participant releases and discharges UAB from any potential claims related to the broadcast or use of their image and any potential claims related to the work. Participant waives any right to inspect or approve the work or the broadcast of their image. This agreement shall be interpreted in accordance with applicable law. This is the entire agreement of the parties, and any changes must be in writing.

Definitions

The following terms have the stated meaning when used in this document:

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