Release And Waiver Liability Form

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2016 STN Convention
Volunteer Information
Release and Waiver Liability Form
Please complete this form if you are volunteering for the 2016 STN Convention, March 10- 13th. Once you
have completed this form please and return it to Student Television Network.
First Name __________________________________ Last Name________________________________
Home/Mailing address___________________________________________________________________
Home Phone_______________________________ Cell Phone__________________________________
Email Address_________________________________________________________________________
Emergency Contact Name____________________________________ Relationship_________________
Home Phone_______________________________ Cell Phone__________________________________
Please check the box if you are under 18 years of age
Volunteers under 18 need to provide written permission from a parent or guardian.
Release and Waiver of Liability
PLEASE READ CAREFULLY!
I execute this Release and Waiver of Liability (the Release) in favor of Student Television Network (STN), a California nonprofit public
benefit corporation, and its directors, officers, employees and agents, and their successors (collectively, Student Television
Network).
I desire to work as a volunteer for Student Television Network and engage in related activities (the Activities) that may include,
among other things, organizing, arranging and coordinating the 2016 STN Convention, which is scheduled to take place in Atlanta,GA
th
th
on March 10
- 13
2016, and other events and meetings of Student Television Network. I hereby freely, voluntarily, and without
duress execute this Release and agree to the following terms and conditions.
1. Assumption of Risk. I understand that the Activities may include work that may be hazardous to me, including, but not limited to,
loading, unloading and moving furniture, lighting, audio-visual equipment and other potentially heavy objects, climbing ladders and
using other equipment, preparing and serving hot food and beverages, and packing and unpacking documents, office equipment and
other articles provided by STN and other entities.
I attest that I am physically and mentally fit and able to engage in the Activities. I hereby expressly and specifically assume the risk of
injury or harm in the Activities and release Student Television Network from all liability or injury, illness, death or property damage
resulting from the Activities.
2. Release and Waiver of Liability. I hereby release and forever discharge and hold harmless Student Television Network from any
and all liability, claims, and demands of whatever kind or nature, whether in law or in equity, and whether incurred as a result of the
negligence of any party or otherwise, which arise or may hereafter arise from my Activities with STN.
I understand that this Release discharges STN from any liability or claim that I may have against STN with respect to any bodily
injury, personal injury, illness, death, or property damage that may result from my Activities with Student Television Network.
Student Television Network does not assume responsibility for, or any obligation to provide, financial or other assistance, including,
but not limited to, medical, health or disability insurance in the event of my injury or illness.

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