ACKNOWLEDGEMENT AND RELEASE OF RISK AND WAIVER OF LIABILITY
Procurement, Contract, & Risk Management Contact Information
Klamath Falls 541-885-1133
3201 Campus Drive, Snell Hall 204, Klamath Falls, OR 97601
Portland-Metro (Wilsonville) 503-821-1277
27500 SW Parkway Ave, Wilsonville, OR 97070
ACKNOWLEDGEMENT AND RELEASE OF RISK AND WAIVER OF LIABILITY
Read this Acknowledgement of Risk and Waiver of Liability carefully and in its entirety. It is a binding legal document. Sign and submit this form electronically to Risk Management.
I, the undersigned, am aware that participation in the Activity (New Student Orientation: SOAR) described above may include activities that may cause injury and be dangerous. I acknowledge that participation in this ACTIVITY has the following non-exhaustive list of particular activities that bear risk and danger and from which bodily injury, up to and including death, may occur:
Various programs & activities; general gameplay; music programs; face or body painting; relay races, dances, or parties; grill/cookout events; films, etc. Any chemicals or other substances that could be a health hazard, activities including work that may be hazardous, including, but not limited to, construction, loading and unloading, and operation of equipment & tools. Electrical safety, manual handling activities, high noise levels, any risk from specific activities or demonstrations, any vehicles, crowd intensity, etc. property damage, or personal injury, that I may sustain, or any loss or damage to property that I own, as a result of being engaged in such activity. It is impossible to know and list every risk associated with the activities, but the risks I may encounter include: slipping, falling, tripping; improper or malfunctioning equipment, and physical contact with others. Any and all risks associated with travel, injuries resulting from natural causes, activities of others, animals, plants, either as a result of any reasons, lacerations, broken bones, head/eye injuries, brain damage, paralysis, back/spine/neck injuries, heart attack, stroke, drowning, and death.
With full knowledge of the facts and circumstances surrounding the ACTIVITY, I voluntarily participate in the ACTIVITY and assume the responsibilities and risks resulting from my participation, including all risks of property damage and injury to others and to myself. I agree to comply with all of the rules and conditions of participating in the ACTIVITY. I agree that I have adequate applicable insurance necessary to provide for and pay any medical costs that may directly or indirectly result from my participation in the ACTIVITY, or otherwise understand that I am solely responsible for any medical costs that may directly or indirectly result from my participation in the ACTIVITY. I will indemnify and hold the Oregon Institute of Technology and its trustees, officers, directors, employees and agents (hereafter referred to as UNIVERSITY) harmless with respect to any and all claims, injuries, and costs associated with my participation in this ACTIVITY.
Furthermore, I acknowledge that I am solely responsible for any action that I participate in associated with this ACTIVITY or around this ACTIVITY, regardless if occurring before, during or after the period of the ACTIVITY. I will conduct myself in a manner that is considerate of other participants and in accordance with UNIVERSITY Rules and Regulations (including the Student Code of Conduct, when applicable) and with any state and city laws or rules where the ACTIVITY is occurring. If this ACTIVITY is an off-campus UNIVERSITY-sponsored event, such as a field trip, conference, research, experiential learning, the extension of classroom learning, etc., I understand that conduct not acceptable in the classroom setting is not acceptable during this ACTIVITY and will be handled in accordance with the Student Conduct Regulations. In addition, I understand that if I travel to the ACTIVITY with a UNIVERSITY group and/or advisor, I will return with the group unless prior arrangements have been made with the UNIVERSITY faculty/staff who is supervising the ACTIVITY.
WE LOVE TO TAKE YOUR PITURE!! I recognize and acknowledge that UNIVERSITY may record my participation and appearance in ACTIVITY on any recorded medium (including, but not limited to video, audio, and photos) for use in any form (including, but not limited to print, websites, blogs, internet). I authorize such recording and release UNIVERSITY to use my name, likeness, voice, and biographical material to exhibit or distribute such recordings in whole or part without restrictions or limitations for any educational or promotional purpose. I further release UNIVERSITY to use material from blogs associated with ACTIVITY without restrictions or limitations for any educational or promotional purpose. *For minor participants, parent/guardian may opt out of this on the reverse side of the form.
I am aware that if I provide a vehicle not owned and operated by the UNIVERSITY for transportation to, at, or from the ACTIVITY site, or if I am a passenger in such a vehicle, the UNIVERSITY is not responsible for any damage caused by or arising from my use of such transportation. Furthermore, I acknowledge that I am solely responsible for any action that I take that is outside the scope of the scheduled ACTIVITY, regardless if occurring before, during or after the period of the ACTIVITY.
To the extent permitted by law, and in consideration for being allowed to participate in the ACTIVITY, I hereby save, hold harmless, discharge and release the UNIVERSITY from any and all liability, claims, causes of actions, damages, or demands of any kind and nature whatsoever that may arise from or in connection with my participation in any activities related to the ACTIVITY, whether caused by the negligence or carelessness of the UNIVERSITY or otherwise.
It is my express intent that this Acknowledgement of Risk and Waiver of Liability shall bind my spouse, the members of my family, and my estate, heirs, administrators, personal representatives, and assigns. I further agree to save and hold harmless, indemnify, and defend the UNIVERSITY from any claim by the aforementioned parties arising out of my participation in the ACTIVITY.
I recognize and acknowledge that the UNIVERSITY makes no guarantees, warranties, representations, or other promises relative to the ACTIVITY, and assumes no liability or responsibility for injury or property damage that I may sustain as a result of participation in the ACTIVITY.
I further understand and agree that this Acknowledgement of the Risk and Waiver of Liability Agreement is intended to be as broad and inclusive as permitted by law. If any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and legal effect.
MEDICAL INFORMATION: I hereby certify that, with or without accommodation*, I have no health-related reasons or problems that preclude or restrict my participation in the ACTIVITY. I hereby consent to and understand myself to be solely responsible for the cost of first aid, emergency medical care, and, if necessary, admission to an accredited hospital for executing such care or treatment for injuries that I may sustain while participating in any activity associated with the ACTIVITY. *If you have a disability requiring accommodation please contact Oregon Tech Disability Services at least one week (7 days) before the date of the ACTIVITY.
Use of Personal Property Event participants bringing personal items, including but not limited to desktop and laptop computers, cellular telephones, computer peripherals, accessories, cables, instruments or sporting equipment do so at their own risk.
Oregon Institute of Technology, its trustees, officers, directors, employees, volunteers, and agents will not be held liable for damage, loss, or theft of personal items, including damage or loss of physical and digital equipment, information, and items regardless of the cause of such damage, loss, or theft.
Event participants will release, hold harmless, and indemnify any staff from liability of any kind or destruction that may arise.
In signing this ACKNOWLEDGEMENT AND RELEASE OF RISK AND WAIVER OF LIABILITY I hereby acknowledge and represent: (a) that I have read this document in its entirety, understand it, and sign it voluntarily; and (b) that this Acknowledgement of Risk and Waiver of Liability is the entire agreement between the parties hereto and its terms are contractual and not a mere recital.
