Release And Waiver Of Liability And Program Participation Agreement University Of Arkansas Education Abroad Programs (Page 3 of 3) in pdf

Release And Waiver Of Liability And Program Participation Agreement University Of Arkansas Education Abroad Programs Page 3

13. Independent Analysis And Binding Authority. I HAVE CAREFULLY READ THIS RELEASE

AND

WAIVER

LIABILITY

AND

PROGRAM

AGREEMENT

AND

FULLY

UNDERSTAND ITS CONTENTS. I FURTHER ACKNOWLEDGE AND AGREE THAT I

HAVE HAD AN OPPORTUNITY TO CONSULT WITH COUNSEL OF MY CHOICE PRIOR

TO EXECUTING THIS RELEASE AND WAIVER OF LIABILITY AND PROGRAM

AGREEMENT. I ACKNOWLEDGE AND AGREE THAT THIS RELEASE AND WAIVER

OF LIABILITY AND PROGRAM AGREEMENT SHALL BE BINDING UPON MY

SURVIVORS, HEIRS, SUCCESSORS, AND ASSIGNS.

I AM AWARE THAT THIS

RELEASE AND WAIVER OF LIABILITY AND PROGRAM AGREEMENT IS A RELEASE

OF LIABILITY, INCLUDING BUT NOT LIMITED TO, LIABILITY FOR NEGLIGENCE,

AND A HOLD HARMLESS AGREEMENT, AND I SIGN IT OF MY OWN FREE WILL.

14. Other Releases. This Release and Waiver of Liability is in addition to and does not revoke or modify

any other agreement or release which I may execute in connection with the education abroad program.

15. Assurances And Consent. I HAVE READ ALL OF THE ABOVE INFORMATION AND

CONSENT TO ALL OF THE FOREGOING PROVISIONS.

I state that I am over the age of eighteen (18) years and am competent to execute this Release and Waiver

of Liability.

Name (Please Print): _________________________________________

Signature:

_________________________________________

Date:

_________________________________________

If a participant is under the age of eighteen (18) years, this Release and Waiver of Liability must be

executed by the participant and the participant’s parents:

Name (Please Print): _________________________________________

Signature:

_________________________________________

Date:

_________________________________________

Parent(s)’ Name (Print): ______________________________________

Parent(s)’ Signature: _________________________________________

Date:

___________________________________

(revised 11/16/09)

Release And Waiver Of Liability And Program Participation Agreement University Of Arkansas Education Abroad Programs Page 3