Auburn University - Office of Professional and Continuing Education
VOLUNTARY WAIVER, RELEASE OF LIABILITY AND
ASSUMPTION OF RISKS
Event Information
Event:
Dates:
Location:
Building Construction Camp
June 9-14, 2013
Campus of Auburn University
Participant Information
Name of Participant:
Parent/Legal Guardian Name (if applicable):
Address:
City:
Phone Number:
Date of Birth:
State:
Zip:
Gender: M
F
PLEASE READ THIS "RELEASE" CAREFULLY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT. THIS FULLY SIGNED FORM MUST BE SUBMITTED
BEFORE ANY PERSON IS ALLOWED TO PARTICIPATE.
I, the undersigned, wish to participate in the Building Construction Camp (hereafter "Camp") on the dates and location as indicated above and, in
consideration or my participation, I hereby agree as follows:
1. Assumption of Risks
I understand that I, as part of my participation in the Camp, will be using power tools and other dangerous equipment, which may require specialized knowledge to operate safely. Furthermore, I
acknowledge, understand and appreciate that as part of my participation in the Camp there are dangers, hazards and inherent risks to which I may be exposed, including the risk of serious physical
injury such as: serious neck and spinal injuries which may result in complete or partial paralysis, head injuries, brain damage, serious injury to internal organs, serious injury to my musculoskeletal
system, broken bones; loss of my hand(s), toe(s), arm(s), leg(s), severe lacerations and cuts which may result in serious and permanent injury, serious injury to and loss of my eye(s), ear(s), or teeth,
and serious injury to other aspects of my general health and well-being; temporary or permanent disability; death; as well as economic and property loss. I further realize that participating in the Camp
may involve risks and dangers, both known and unknown, and have elected to take part. To a large extent, these risks, dangers and hazards derive from the nature of the activities and the environment in
which they take place. I also understand that the risks in participating in the Camp include not only the foregoing physical injuries, but also impairment of my future abilities to earn a living, to engage
in other business, social and recreational activities, and generally enjoy life. I agree that if I am not knowledgeable of the risks associated with Camp activities that I will obtain proper instruction in
order to gain a full appreciation of the risks, dangers and hazards prior to my participation.
I understand that these injuries may result from certain dangers and risks which are present and which include, but are not limited to, the following: use of tools and equipment; falling objects from work
being conducted overhead; lifting and carrying of building tools, equipment and building materials; falls onto the work surface or falls from elevated work areas; and use of building materials
containing hazardous chemicals or sharp-pointed surfaces.
I agree that I will follow all instructions given to me during the Camp regarding construction safety, the use of power tools and the use construction equipment. I further agree that I will obtain proper
instruction if I am not knowledgeable or do not understand the instructions given to me. I understand that it is my duty and responsibility to seek this instruction. I agree that I will not engage in
behavior injurious to the enjoyment of the Camp by others. I understand and agree that I will follow all safety precautions required for participation.
I am aware that the Camp activities involve strenuous exertion of strength using various muscle groups, physical movements and change of direction, and sustained physical activity which places stress
on the musculoskeletal and cardiovascular system. I declare and affirm that my medical and physical condition allows me to perform such physical activities and does not pose any danger to my health.
Therefore, having understood all of the above, I voluntarily accept and resume all risk of injury, loss of life or damage to property arising out o training, preparing, participating and traveling to or from
the Camp. I understand that I am responsible for my own insurance.
2. Waiver of Claims
I hereby release the Auburn University Office of Professional and Continuing Education, Auburn University, its Board of Trustees, Administration, Faculty, Staff, Student Leaders, and all other
officers, directors, employees and agents (hereafter "Auburn") from any and all liability as to any right of action that may accrue to my heirs or representatives for any injury or loss that I may suffer
while training, preparing, participating and/or traveling to or from the Camp. This agreement is binding on my heirs and assigns.
3. Hold Harmless
I furthermore release, indemnify and hold harmless Auburn from and against any and all liability, actions, debts, claims and demands of every kind whatsoever, specifically including, but not limited to,
any claim for negligence or negligent acts or omissions and any present or future claim, loss or liability for injury to person or property that I may suffer, for which I may be liable to any other person,
that may or does arise out of my participation in the Camp. I understand that Auburn accepts no responsibility for my personal property.
4. Choice of Law
This RELEASE shall be governed by and construed under the laws of Alabama. I agree that any legal action or proceeding relating to this RELEASE, or arising out of any injury, death, damage or loss
as a result of my participation in any part of the Camp, shall be brought only in Lee County, Alabama.
This RELEASE contains the entire agreement between the parties to this agreement and the terms of this RELEASE are contractual and not a mere recital. The
information I have provided is disclosed accurately and truthfully. I have been given ample to read this document and I understand and agree to all of its terms
and conditions. I understand that I am giving up substantial rights (including my right to sue), and acknowledge that I am signing this document freely and
voluntarily, and intend by my signature to provide a complete and unconditional release of all liability to the greatest extent allowed by law. My signature on
this document is intended to bind not only myself but also my successors, heirs, representatives, administrators, and assigns.
A PARENT OR GUARDIAN MUST SIGN THIS FORM FOR A MINOR UNDER THE AGE OF 19
Parent/Guardian Name
Parent/Guardian Signature
Date