Fillable Printable Release of Liability and Promise Not to Sue - California State University

Release of Liability and Promise Not to Sue - California State University

RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND

AGREEMENT TO PAY CLAIMS

Activity: ______________________________________________________________________

______________________________________________________________________________

Activity Date(s) and Time(s): _____________________________________________________

Activity Location(s): ____________________________________________________________

In consideration for being allowed to participate in this Activity, on behalf of myself and my

next of kin, heirs and representatives, I release from all liability and promise not to sue the

State of California, the Trustees of The California State University, California State University,

[campus name] and their employees, officers, directors, volunteers and agents (collectively

“University”) from any and all claims, including claims of the University’s negligence,

resulting in any physical or psychological injury (including paralysis and death), illness,

damages, or economic or emotional loss I may suffer because of my participation in this

Activity, including travel to, from and during the Activity.

I am voluntarily participating in this Activity. I am aware of the risks associated with traveling

to/from and participating in this Activity, which include but are not limited to physical or

psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability

(including paralysis), economic or emotional loss, and/or death. I understand that these injuries

or outcomes may arise from my own or other’s actions, inaction, or negligence; conditions

related to travel; or the condition of the Activity location(s). Nonetheless, I assume all related

risks, both known or unknown to me, of my participation in this Activity, including travel

to, from and during the Activity.

I agree to hold the University harmless from any and all claims, including attorney’s fees or

damage to my personal property, that may occur as a result of my participation in this Activity,

including travel to, from and during the Activity. If the University incurs any of these types of

expenses, I agree to reimburse the University. If I need medical treatment, I agree to be

financially responsible for any costs incurred as a result of such treatment. I am aware and

understand that I should carry my own health insurance.

I am 18 years or older. I understand the legal consequences of signing this document,

including (a) releasing the University from all liability, (b) promising not to sue the

University, (c) and assuming all risks of partic ipating in this Activity, including travel to,

from and during the Activity.

I understand that this document is written to be as broad and inclusive as legally permitted by the

State of California. I agree that if any portion is held invalid or unenforceable, I will continue to

be bound by the remaining terms.

I have read this document, and I am signing it freely. No other representations concerning the

legal effect of this document have been made to me.

Participant Signature: _______________________________________

Participant Name (print):_________________________________ Date: ____________

If Participant is under 18 years of age:

I am the parent or legal guardian of the Participant. I understand the legal consequences of

signing this document, including (a) releasing the University from all liability on my and

the Participant’s behalf, (b) promising not to sue on my and the Participant’s behalf, (c)

and assuming all risks of the Participant’s pa rticipation in this Activity, including travel to,

from and during the Activity. I allow Participant to participate in this Activity. I understand

that I am responsible for the obligations and acts of Par ticipant as described in this document. I

agree to be bound by the terms of this document.

I have read this two-page document, and I am signing it freely. No other representations

concerning the legal effect of this document have been made to me.

__________

Signature of Minor Participant’s Parent/Guardian

__________ ___________________

Name of Minor Participant’s Parent/Guardian (print) Date

______________________________

Minor Participant’s Name