Waiver Of Liability And Hold Harmless Agreement
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1Volunteer
V
/P
R
OLUNTEER
ARTICIPANT
ECORD
CONSISTING OF
A C
A
W
L
& H
H
ONTRACT
GREEMENT WITH
AIVER OF
IABILITY
OLD
ARMLESS
Activity/Program/Enrollment for : _______________________________________________________________.
The undersigned
for good and valuable consideration, receipt of which is hereby acknowledged, and in consideration for being
allowed voluntary participation or enrollment in said forgoing program, with such program or event to be provided by, at or through
UCO, agrees with UCO’s terms and conditions as follows:
1. Waiver:
I,
, have volunteered to participate in the activity
identified above. I am over eighteen (18) years of age (or if under 18, have asked my parent or guardian to sign this document in
addition to my own signature) and am eligible and medically and physically capable and qualified to participate in the above-named
activity/program. I will work/participate at the direction of UCO, its agents, and employees, and follow all applicable rules,
regulations, and laws, but I am not an employee of UCO nor am I an independent contractor, and thus I am not qualified for coverage
under UCO’s workers’ compensation. Should I desire insurance protection I will provide my own insurance and hereby advise UCO
that I engage in this volunteer activity totally accepting my own risk of participation. Should I require a need for medical attention, I
give permission for UCO to contact an emergency transport to take me to a doctor/medical facility.
Further -- I recognize that I am not required to participate in this Activity. However, I choose to do so of my own free will
recognizing the inherent risk involved in my participation in the Activity, including but not limited to:
1. Transportation associated with this Activity;
2. Risks associated with the location of the designated activity;
3. Using the apparatus, equipment, and uniforms or personal protective equipment required of the activity;
4. Injury which could be potentially serious, and / or could lead to death, if I am not physically qualified and myself or
others engaged in this activity do not follow safety precautions required of the activity;
5. Participation by me with others in this activity is inherently dangerous as I have to rely on my conduct as well of that of
other individuals to stay safe, and,
6. My conduct in this activity may make me liable for damages and injury to others if I am negligent.
2. Hold Harmless:
By signing below I voluntarily assume all risks of loss, property damage, or personal injury, including death, that I may
sustain or cause as a result of participating in this Activity, whether caused by my negligence or that of UCO or its officers, agents or
employees, in The ______________________________________________________ Activity/ Program, and agree not to make any
claim of any kind against UCO, its officers, agents or employees and/or the Regional University System of Oklahoma for any such
loss, property damage, or personal injury. I FURTHER AGREE TO INDEMNIFY AND HOLD HARMLESS UCO, its officers,
agents and employees and/or the Regional University System of Oklahoma from any loss, liability, damage or costs, including court
costs and attorneys fees, that they may incur due to my participation in such Activity, whether due to my negligence or theirs.
I hereby bind other members of my family, my heirs and assigns to this Waiver of Liability and Hold Harmless Agreement.
3. Acknowledgement:
I have read this document before signing it; I have had an opportunity to consider its meaning, and I understand the
document and sign it as my own free act and deed. I am at least 18 years of age and fully competent, or if under the age of 18, my
parent and/or legal guardian signs on my behalf intending to be as fully bound as though I were of age and able to sign for myself. I
also sign with the understanding and agreement with UCO that UCO or the individual or group conducting this Activity/Program will
do so in a professional manner and use reasonable care as to my safety that would ordinarily be expected for an Activity/Program such
as this.
In Witness whereof I/we have set my/our hand this _________day of _____________________, 20______.
Participant:
Printed Name:_________________________________
Signature: _____________________________________
Other Signature: (Guardian or Parent if Participant under 18 years of age)
Print Name___________________________________
Signature _____________________________________
Note: For those under 18, the participant and parent or guardian must both sign.
The Using UCO Department is required to send a copy of this signed form to the UCO Office of Legal Counsel
Approved as to Form 071106
UCO Office of Legal Counsel JBM
Volunteer Standard Waiver and Indemnity Form 2006
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