Liability Waiver Form

Liability Waiver Form
2015 __________________________
Assumption of Risk, Release of Claims, Indemnification,
and Hold Harmless Agreement
The parties to this Agreement are
______________________________ (Participant),
____________________________ (Participant 's parents
or legal guardian, if Participant is under 18, all referred to
hereafter jointly and severally as "Participant") and the
Board of Trustees of the Leland Stanford Junior University
its officers, trustees, faculty, agents, representatives,
volunteers, students and employees ("Stanford”) for the
_______________________________________ (“Event”)
(“Stanford” and “Event” are collectively referred to
hereafter as “Released Parties”).
Participant is a voluntary participant in this Event.
Participant understands and agrees that such activities
may be dangerous, may involve travel (local, domestic
and/or international) and that neither the Event nor
Stanford can guarantee the safety of Participant.
Participant shall not engage in inappropriate conduct
including the use of physical force or verbal abuse, abuse
of the customs or mores of the community, and
unauthorized absences from classes or other activities.
Participant is apprised that Released Parties shall not be
subject to claims or suit to be made by or on behalf of
Participant or Participant’s heirs, representatives or
assigns as a consequence of Participant’s participation in
the Event.
Assumption of Risk. Participant expressly understands
and agrees that the Event presents risks to Participant and
her/his property. These risks can include, among others
(by way of example and without limitation): dangers
associated with swimming and drowning, manmade and
natural jumps; dangers of collision with pedestrians,
vehicles, and fixed or moving objects; the dangers arising
from surface hazards, including pot holes or other ground
or pavement depressions or height differentials, equipment
failure, teammates’ or co-participants’ negligent or
wrongful conduct, inadequate safety equipment or training,
use of equipment or materials provided by the event
organizer, host and others; unfamiliar or different terrain;
customs, climate, food and drink; civil unrest, terrorism,
kidnapping and assault; laws; social and sexual mores;
personal safety; driving practices; sports practices, rules
and regulations; communications; criminal and law
enforcement activities; disability access; driving practices,
road, premises conditions and/or maintenance; disease
risks; inadequate health care; injury to the head, neck or
spine; injury to the muscular or skeletal systems; injury to
internal organs; scratches, bruises, strains, sprains,
contusions, falls, fractures; physical violence; verbal
abuse; sexual abuse or other forms of harassment by coparticipants; loss or damage to sight, teeth; other body
2015 Individual Waiver
parts or hearing; paralysis; concussions; brain damage;
long and/or short-term disability; loss of income and/or
career and earning opportunities; minor or serious injury
and/or death or other risks, including risks related to
explosion, fire, chemical exposure and/or risks associated
with field trips. Participant is responsible for researching
and evaluating the risks he/she may face and is
responsible for his/her actions. Any activities that
Participant may take part in, whether as a component of
the Event or separate from it, will be considered to have
been undertaken with Participant's approval and
understanding of any and all risks involved. This includes,
but is not limited to, risks associated with the consumption
of alcoholic beverages and/or drugs or other intoxicants
(whether legal or illegal), property loss, injury to person or
property, or death arising out of traffic accidents, assault,
and theft or other activities.
It is Participant’s intention that this assumption of all
risks shall be legally binding and a complete bar to
Participant, Participant’s heirs, personal
representatives, relatives and assigns. This
assumption of risk applies to all activities arising out
of, associated with or resulting directly or indirectly
from Participant’s participation in the Event, including
but not limited to those risks listed above.
Participant further recognizes, understands and agrees
that the Released Parties assume no responsibility for any
liability as regards damage or injury that may be caused by
Participant’s negligence or willful acts committed prior to,
during or after participation in the Event, or any liability,
damage or injury caused by others, including other
participants.
Adherence to Standards. Participant understands and
agrees to abide by all Stanford policies, rules, and
regulations and to all other laws, rules and regulations,
including all office, laboratory and/or general campus rules
and regulations.
Release of Claims. In consideration of being accepted
into and/or participating in the Event, Participant agrees for
Participant and on behalf of Participant’s heirs, executors,
administrators, employers, agents, representatives,
insurers, and attorneys, to release and discharge Stanford
of and from any and all claims which may arise from any
cause whatsoever, including any negligent act or omission
by Stanford or others. Participant further releases and
discharges Stanford from liability for any accident, illness,
injury, loss or damage to personal property, or any other
consequences arising or resulting directly or indirectly from
Participant's participation in the Event. The Participant
acknowledges and agrees that the Released Parties
assumes no responsibility for any liability, damage, or
injury that may be caused by Participant's negligent or
intentional acts or omissions committed prior to, during, or
after participation in the Event, or for any liability, damage,
or injury caused by the intentional or negligent acts or
omissions of others, including other participants.
Participant intends that both the assumption of risk and the
release of claims be complete defenses to any and all
actions, claims or demands that Participant, Participant’s
heirs or legal representatives have or may have for injuries
to person or property, including death, as a result of
activities for which the participant has assumed risks
and/or released and/or waived claims.
Indemnification and Hold Harmless. Participant hereby
agrees to indemnify, defend, and hold harmless Released
Parties from any injury, loss or liability whatsoever
including reasonable attorneys' fees and/or any other
associated costs, from any action, claim, or demand that
Participant, Participant’s heirs or legal representatives, has
or may have for any and all personal injuries Participant
may suffer or sustain, regardless of cause or fault as a
result of, arising out of, associated with, or resulting
directly or indirectly from Participant’s voluntary
participation in or decision to participate in the Event,
travel to and from the Event and any and all related
activities, on or off of Stanford’s campus. This
Indemnification and Hold Harmless Agreement is
intended to be all encompassing.
Physical Condition and Insurance. Participant attests
that he/she is physically and mentally capable of
participating and has no known health restrictions that
might jeopardize his/her safety or health or the safety or
health of others during their participation in the Event.
Participant gives permission for Stanford or its
representative to provide immediate and reasonable
emergency care should it be required.
Participant agrees to be solely responsible for payment in
full of all costs of medical care he/she may receive.
Activities Outside the Event. Should Participant choose
to remain at the Event location or elsewhere either before
or after participation in the Event then this Agreement shall
remain in full force and effect.
Event Modification and Cancellation. Stanford reserves
the right to cancel or modify the Event before or during its
operation for any reason, including emergencies, low
enrollment, or unavailability of facilities or personnel.
Termination of Participation. Participant shall not
engage in inappropriate conduct. Participant understands
that, in its sole discretion, Stanford or its representative
may terminate Participant's participation in the Event at
any time, including during the Event. Reasons for
termination may include, but are not limited to:
inappropriate conduct or other behavior by Participant
deemed detrimental to the best interests of the Event, or
health or safety considerations. Such termination shall not
diminish or otherwise alter Participant's obligation to make
any payment required for the Event, nor shall Stanford be
required to make any refund.
Severability. It is understood and agreed that, if any
provision of this Agreement or the application thereof is
held invalid, the invalidity shall not affect other provisions
or applications of this Agreement which can be given effect
without the invalid provisions or applications. To this end,
the provisions of this Agreement are declared severable.
Governing Law and Venue. This Agreement shall be
construed in accordance with, and governed by, the laws
of the State of California. The venue for any action arising
out of this Agreement shall be the County of Santa Clara,
State of California. The parties agree to submit to
jurisdiction in Santa Clara County, California.
Construction and Scope of Agreement. The language of
all parts of this Agreement shall in all cases be construed
as a whole, according to its fair meaning, and not strictly
for or against any party. This Agreement is the only, sole,
entire, and complete agreement of the parties relating in
any way to the subject matter hereof. No statements,
promises, or representations have been made by any
party to any other, or relied upon, and no consideration
has been offered or promised, other than as may be
expressly provided herein. This Assumption of Risk,
Release of Claims, Indemnification, and Hold Harmless
and Agreement supersedes any earlier written or oral
understandings or agreements between the parties.
Participant acknowledges that he/she has read this
Assumption of Risk, Release of Claims,
Indemnification and Hold Harmless Agreement,
understands its meaning and effect, and agrees to be
bound by it.
Date:
Participant Signature:
______________________________________________
Participant’s Name Printed:
______________________________________________
Date:
Signature of Custodial Parent or Legal Guardian (if
Participant under 18):
______________________________________________
Custodial Parent or Legal Guardian Name Printed:
______________________________________________
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