Emergency Contact Sheet (Page 2 of 4) in pdf

Acknowledgement of Risk and Release and Waiver of Liability Form

Acknowledgement of Risk: As parent or legal guardian of the child whose name appears below, I acknowledge that there are certain

risks inherent in my child’s participation in the High School Law Institute (“HSLI”), at New York University School of Law which will

take place from October 2014 through April 2015. These risks include, without limitation, risks associated with travel to, from, and in

and around New York City and my child’s participation in supervised and unsupervised activities while at HSLI. I also acknowledge

that any questions I or my child have about activities or travel related to HSLI can be addressed to representatives of HSLI or New

York University (the “University”). I agree that I will inform an appropriate representative of HSLI of any special information

regarding the health, or physical or mental condition of my child that may be relevant to my child’s participation in HSLI.

Waiver: In consideration for permitting my child to participate in any way in HSLI, I, for myself, my heirs, personal representatives or

assigns, do hereby agree to release, waive, and discharge, and covenant not to sue the University, its officers, employees, and agents

or servants, including any representatives of HSLI, from any liability or responsibility for any personal or bodily injury, accidents or

illnesses (including death), and for any damage to or loss of property, however caused, that my child or I suffer as a result of or in

connection with my child’s participation in HSLI or any travel related to HSLI, including, without being limited to, any injury, loss, or

damage resulting from, arising out of, or occurring in connection with the negligent acts or omissions of members of the faculty or

staff or other employees, agents or servants of the University or HSLI.

I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the

participation in HSLI. I hereby assert that my participation is voluntary and that I knowingly assume such all risks.

Indemnification and Hold Harmless: I also agree to indemnify and hold the University harmless from any and all claims, actions,

suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in the

participation in HSLI and to reimburse them for any such expenses incurred.

All references to the University in this form will include, and all provisions of this form will inure to the benefit of, the University’s

trustees, officers, employees, agents, servants, and representatives, including any representatives of HSLI.

This acknowledgment of risk and release and waiver of liability are governed by and will be construed as broadly and inclusively as is

permitted by and in accordance with the laws of the State of New York without regard to principles of conflicts of law, and that if

any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I agree

that I will submit to the exclusive jurisdiction of the federal and state courts located in New York County, New York State, for the

resolution of all disputes arising hereunder or relating hereto, regardless of the place of execution of this form.

I have read this wavier of liability, acknowledgement of risk, and indemnity agreement, fully understand its terms, and

understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely

and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent

allowed by law.

Student Name (print name) ___________________________________________________

Date_______________

Student Signature ___________________________________________________________

Student Age_________

Parent/Legal Guardian (print name) ____________________________________________________________________

Parent/Legal Guardian Signature _______________________________________________________________________

40 Washington Square South ● New York, NY 10012 ● ●

Emergency Contact Sheet Page 2