General Waiver - University Of Toledo printable pdf download

LIABILITY RELEASE AND COVENANT NOT TO SUE

I, Participant ______________________________________ [print full legal name of Participant] whose address is

_____________________________________ and ________________________________________________________

[print full legal name plus address of Participant’s Parent or Guardian if Participant is a Minor] request that the

Participant

granted

permission

participate

the

following

activity/trip:

___________________________________ on ______________ [date] (“Activity”). We understand the risks inherent

in this Activity, which may include: ____________________________________________________ [insert type of

activities] and transportation to, during or from the Activity. We understand the Participant’s safety depends on

Participant’s own good judgment, adequate preparation and constant attention.

In consideration of Participant being permitted to participate in this Activity, we the undersigned do hereby release,

waive, forever discharge and covenant not to sue the State of Ohio, the University of Toledo, its trustees, officers,

agents, employees, any students or members of any sponsoring organization (“Releasees”) from and against any and

all liability for any harm, injury, claims, damage, actions, causes of actions, costs and expenses of any nature which

Participant may have or which may hereafter accrue to Participant, arising out of or related to any loss, damage or

injury, including but not limited to suffering and death, that may be sustained by Participant or by any property

belonging to Participant, whether caused by the negligence or carelessness of the Releasees, or otherwise, while

Participant 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. It is our express intent that this Liability Release and Covenant Not To Sue Agreement

(“Agreement”) shall bind the members of Participant’s family, estate, heirs, administrators, personal representatives

or assigns.

We understand and agree that Releasees may not have medical personnel available at the location of the Activity. We

understand and agree that Releasees are granted permission to authorize emergency medical treatment, if necessary

and that such action by Releasees will all be subject to the terms of this Agreement not to sue. We understand that the

Releasees assume no responsibility for any injury or damage, which might arise out of or in connection with such

authorized emergency medical treatment.

In signing this Agreement, we acknowledge that we have reviewed and understand what the above means and that this

document is signed as a free act and deed. We further state that there are no health-related reasons or problems which

preclude or restrict the Participant’s participation in this Activity and that Participant has adequate health insurance

necessary to provide for and pay any medical costs that may be attendant as a result of injury to Participant. We

further agree that this Agreement will be construed in accordance with the laws of the State of Ohio.

I, [for Minor] Participant’s Parent or Guardian, further state than I am fully competent to sign this Release and

Covenant Not To Sue Agreement; and that I execute this Release for full, adequate and complete consideration fully

intending for myself, for Participant and Participant’s family, estate, heirs, administrators, personal representatives or

assigns to be bound by the same.

THIS IS A RELEASE OF LEGAL RIGHTS. READ BEFORE SIGNING

STUDENT/PARTICIPANT

WITNESS

___________________________ _______

_________________________________

(Signature)

(Date)

(Signature)

_________________________________

(Print Name)

PARENT OR GUARDIAN (only necessary if minor)

___________________________ _______

(Parent’s or Guardian’s Signature) (Date)

Liability Control 1/10/05

General Waiver - University Of Toledo

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