WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
International Students and Scholars Office, University of Northern Iowa
In exchange for participation in the activity of Day Trip to the Mall of America organized by the
International Students and Scholars Office at the University of Northern Iowa, I,
________________________________________________ agree for myself and my family (if applicable)
to the following:




I agree to observe and obey all posted rules and warnings, and further agree to follow and oral
instructions given by ISSO staff, or employees of the trip destination, or bus driver.
I recognize that there are certain inherent risk associated with the describe activity and I assume
full responsibility for personal injury to myself (and if applicable) my family members, and
further dismiss ISSO for injury, loss or damage arising out of my or my family’s use of or
presence upon the facilities of ISSO.
ISSO is not responsible for any lost or stolen goods.
I agree and acknowledge that I am under no pressure or duress to sign this agreement and that I
have been given a reasonable opportunity to review it before signing.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS
RELEASE, I AGREE TO THE ABOVE STATEMENTS.
Date:
___________ (MM/DD/YYYY)
Signature:
________________________________________________