Common use of RELEASE AND WAIVER OF LIABILITY Clause in Contracts

RELEASE AND WAIVER OF LIABILITY. This activity is being offered through Marymount University in Arlington, VA. As used herein, “Marymount” includes Marymount University, the Department of Education and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am the parent or guardian of , and I acknowledge that I am entering into this waiver and release of liability knowingly and voluntarily and I confirm the participant is in good physical condition and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As such, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide by the Marymount University rules, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and re-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined above. I understand that the photographs taken by the staff or their designers of Marymount University will be included in the Department files. I agree the images, the transparencies of the images, and the copyright privileges of the images shall be the sole property of Marymount University. I acknowledge that I have read this document carefully and fully understand its contents. I agree that, should any provision or aspect of this agreement be found to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse or other person you would like Marymount University to contact in the event of an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears on the next pages. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Name: has the following ALLERGENS: (This form will be made available to camp staff.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity is being offered through Marymount University In consideration for the Program to allow my child to participate in Arlingtonthe Program, VA. As used hereinI, “Marymount” includes Marymount Universityas parent and/or guardian, authorize my child to participate in the Department of Education Program and their employeesrelease, agentsdischarge and hold harmless the Program and RIT, its program directors, staff, clinicians and all other officers, directors, employees, volunteers, and affiliatesagents from any claims or liability arising from my child’s participation in the Program. Activity: 3E: ExploreThis Consent, EnrichRelease, Enjoy Summer Camp Session I Waiver and Session II Date(s): July 6 – 17Assumption of Risk Agreement (“Agreement”) is governed by and shall be construed under the laws of the State of New York without regard to the principles of choice of law. Any claims, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am demands, or actions arising under this Agreement must be brought in the parent state or guardian federal courts in the State of New York, Monroe County, and I acknowledge that I am entering into consent to the jurisdiction of the State of New York for all purposes under this Agreement. This Agreement is a continuing consent, release, waiver and release assumption of liability knowingly risk with no limitations or reservations, unless and voluntarily and I confirm the participant is in good physical condition except those stated herein, and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As suchbinding on me and my child and our heirs, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is requiredexecutors, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possibleadministrators, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide by the Marymount University rules, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and re-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, assigns and all people acting under their permission or authoritysuccessors in interest. Any copy of this document has the full force and effect and is as binding as the original. In signing this Agreement, from any liability in connection with the use of the images as outlined above. I understand that the photographs taken by the staff or their designers of Marymount University will be included in the Department files. I agree the images, the transparencies of the images, and the copyright privileges of the images shall be the sole property of Marymount University. I acknowledge that I have read both pages of this document carefully Release Agreement form, understand it, and fully understand agree to be bound by its contentsterms. I agree that, should any provision further acknowledge that I am the parent or aspect of this agreement be found to be unenforceable, that all remaining provisions legal guardian of the agreement will remain Participant and that I sign this Release Agreement voluntarily. Name of Parent or Guardian (printed) Signature Date Name of Participant (printed) Signature Date THIS IS A RELEASE OF LEGAL RIGHTS AND AN ACKNOWLEDGEMENT AND ASSUMPTION OF RISK. READ AND UNDERSTAND BEFORE SIGNING. ACTIVITY DETAIL FORM (To be completed by Program Director) Name of Activity: Next Big Idea Date(s) of Activity: January, February & March 2024 Description of Activity: Webinar and Zoom meeting with teams. I am fully aware of the risks and hazards associated with the activity, and hereby elect to voluntarily participate in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse or other person you would like Marymount University to contact in the event of an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears on the next pages. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Name: has the following ALLERGENS: (This form will be made available to camp staffthis activity.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity Alternative Break Experience (ABE) Service Trip Group Agreement and Release and Waiver of Liability is being offered through Marymount University in Arlington, VA. As used herein, “Marymount” includes Marymount University, the Department of Education executed and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am the parent or guardian of , and I acknowledge that I am entering into this waiver and release of liability knowingly and voluntarily and I confirm the participant is in good physical condition and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As such, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide given by the Marymount undersigned to Saint John’s University rules(collectively “St. John’s”) and the College of Saint Benedict, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and rea Minnesota non-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined aboveprofit corporation (“CSB”). I understand that the photographs taken Alternative Break Experience program that is sponsored by the staff College of St. Benedict Campus Ministry department is a service, educational and social justice opportunity. I am freely choosing to go on this trip, and within reason, I am willing to do the service work that is asked of me by the experience. As an adult, I agree to take responsibility for my behavior and safety during the course of this trip, including acknowledgment of my own limitations. I will act consciously and maturely. I will respect and care for my fellow volunteers, the site leaders, and those for whom I am offering my service. I will contribute my efforts toward the good of the whole group and the complete experience that the ABE program offers. Safety is a primary concern of the ABE program. The poverty and injustice we seek to address through service can lead to unsafe situations. I understand that the activities may be hazardous to myself and may include, but are not limited to: construction, loading, unloading, and transportation to and from sites. I recognize that the activities may, in some situations, be inherently dangerous. I will cooperate with the ABE co-leaders and host site leaders to promote a safe environment and understand that some aspects of the trip may be changed or canceled to address safety. I will respect the authority and responsibility of the co-leaders and will abide by their designers decisions. In keeping with that respect, I will speak up on my behalf or the behalf of Marymount University others when I disagree with the way in which important matters are being handled. In full recognition and appreciation of the dangers and hazards inherent in participation in the ABE program, signing this release discharges CSB/SJU from any liability or claim that I may have against CSB/SJU with respect to any bodily injury, personal injury, illness, death or property damage that may result from an alternative break trip, whether caused by the negligence of CSB/SJU or its trip facilitators. I hereby agree to assume all the risks and responsibilities surrounding my participation in these activities or any other activities undertaken as an adjunct thereto. Though I may be of legal age to drink alcohol, I agree to abide by the ABE policy that prohibits the consumption of alcohol. This policy is established as a way to enhance our commitment to service, focusing our energy on what’s important and essential throughout the service experience. In addition, this policy is enforced out of respect for the people we visit for whom alcohol is an expensive luxury and one that might be abused. Additionally, it is also out of respect for under-age participants who would otherwise be excluded from alcohol-related activities. I will uphold the law, and take full responsibility for my actions during the course of this service trip including the use of any controlled substances. If I break the law or break ABE policies, I understand I may be sent home immediately at my own expense and I will be included subject to the laws and regulations of the host site and the College of Saint Benedict and Saint John’s University. Except as otherwise agreed by the College of St. Benedict/St. John’s University in writing, I hereby release and forever discharge the Department filesCollege of St. Benedict/ St. John’s University from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with my participation. I agree also understand that the imagesCollege of St. Benedict/St. John’s University does not carry or maintain health, the transparencies medical, or disability insurance coverage for any participant. I am expected and encouraged to obtain my own medical or health insurance coverage. I understand that there may be health-related risks in connection to my trip. If I am a member of the images, and the copyright privileges of the images shall be the sole property of Marymount University. an international trip I acknowledge that I have read this document carefully and fully understand its contentsbeen advised by the ABE staff and/or co-leaders to seek medical advice in regards to immunizations pertinent to my host country. I agree that, should any provision or aspect understand that costs of these immunizations are my own. I take full responsibility for meeting the financial responsibilities of this agreement be found trip including making payments by the set deadlines. CSB/SJU does not assume any responsibility for or obligation to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse provide financial assistance or other person you would like Marymount University assistance, including but not limited to contact medical, health or disability insurance in the event of injury or illness. I hereby expressively and specifically assume the risk of property damage, injury, death or illness resulting from my activities as an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears Alternative Break Experience program participant. ABE trips begin on the next pagesfirst day of travel and end on the last scheduled day of travel– upon return to Minnesota/the CSB/SJU campuses. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS I will travel to the site with the group and return with my group. I hereby defend, hold harmless, indemnify, release, and forever discharge CSB/SJU, Campus Ministry offices, trip facilitators and their successors and assigns from and against any and all claims, demands, actions, causes of action, damage to personal property, personal injury, death, arrest, or criminal or civil prosecution (including legal fees, fines, court costs or penalties) which may result from my volunteer assignments, activities, transportation, or work experiences on an Alternative Break Experience. By signing below, I acknowledge my agreement with all of the statements on this Group Agreement and Release and Waiver of Liability. Trip Name: has the following ALLERGENS: (This form will be made available to camp staff.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This Pole Dancing is a Dangerous Activity I understand, acknowledge and agree that Pole Dancing is a dangerous activity is being offered through Marymount University and as such, has inherent dangers and risks, including risk of injury or death. I further acknowledge and agree that due to the nature of Pole Dancing, it would be unreasonable for the Pa Pole Academy to be in Arlingtonany way responsible for any injury of any kind or death, VA. As used hereinand I hereby, “Marymount” includes Marymount Universityto the full extent permitted by law, waive all legal rights of action against and fully releases the Department of Education and their Pa Pole Academy, its directors, instructors, employees, agents, officerslandlords, directorsleases or franchisees for the loss, damages, or injury howsoever arising out of or in relation to the participation by myself in the activities conducted or organized by the Pa Pole Academy including without limitation, liability for any negligent or tortious act or omission, breach of duty, breach of contract or breach of statutory duty on the part of the Pa Pole Academy or Related Parties. I understand and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (acknowledge the dangers associated with the consumption of alcohol or any mind altering drugs before and after camp hours also provided 8-6) I hereby certify I am during the parent or guardian of , activity and I acknowledge take full responsibility for any injury, loss or damage associated with their consumption. I agree that participating in any activity organized or conducted by the Pa Pole Academy is only allowed on the distinct understanding that I am entering into this waiver do so at my own risk. Last Modified: 7/30/2015 Conduct I agree to follow the directions of the instructor and release that any misconduct or refusal by me to follow any direction of liability knowingly the instructor can result in the cancellation of my lesson and voluntarily and I confirm my immediate removal from the participant is in good physical condition and is capable of participating in this programclass. I understand that Marymount does not provide health insurance for individuals participating any such non-compliance may result in activities made available or sponsored by Marymountinjury of any kind whatsoever as a result of my failure to comply. As such, Health I acknowledge I have been advised to consult with my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact physician with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide by the Marymount University rules, policies and procedures, in addition respect to any specific rules past or present injury, illness, pregnancy or any other health related condition or any kind whatsoever that may apply affect my participation and ability to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and re-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined above. I understand that the photographs taken by the staff or their designers of Marymount University will be included participate in the Department files. I agree the images, the transparencies of the images, and the copyright privileges of the images shall be the sole property of Marymount Universityprogram. I acknowledge that I have discussed the appropriateness of the Pole Dancing program in connection with any illness or condition that I have or have had with my physician, and that I knowingly execute this release from liability and negligence. I acknowledge that the Pa Pole Academy does not recommend that pregnant women participate in Pole Dancing. The Academy Rental Space The U.S. Environmental Protection Agency (EPA) has been working with the owner of the building where the Academy is located to remove soil near the building which was contaminated by certain chemicals many years ago. This condition can affect the air in the building. The EPA has installed special equipment to measure and filter the air in portions of the premises, including the Academy's space. The Pennsylvania Department of Health has found that most of the premises to be safe for visitors especially if their visits are less than 8 hours a day for many consecutive days. The air filters have improved the quality of the air and the parties are working towards continued improvement. Only a portion of the Academy's space was subject to the recommendation that visitors should try to limit the duration of visits to under four hours for each visit on consecutive days. The area subject to this suggestion is the aerial training portion of the Academy. It is not likely that a member normally would be using this equipment for such an extended period of time during their exercise program. Nonetheless, we wish to advise you of this information and you acknowledge that you understand this advice and will seek to abide by such recommendations to protect your health. Do not ignore such recommendations; because you do so at your own risk. EFFECT OF THIS DOCUMENT I have had sufficient opportunity to read this document carefully entire agreement and fully understand its contentsterms and sign it freely and voluntarily without inducement of any kind. I agree that, should any provision or aspect of this agreement be found to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse or other person you would like Marymount University to contact in the event of an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: CellDated: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears on the next pages. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Name: has the following ALLERGENS: (This form will be made available to camp staff.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity is being offered through Marymount University I understand in Arlington, VAregards to my volunteer activities under the Adopt-A-Trail Litter Cleanup Program. As used herein, “Marymount” includes Marymount University, the Department of Education and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am not employed or an agent of the parent or guardian City of , Wichita Falls and I acknowledge am not covered by any insurance or worker’s compensation coverage by virtue of the Cleanup Agreement or by my participation in the Program. I fully understand that there is a risk whenever I am on the Trail right-of-way, or near traffic. I fully understand the risks of picking up litter along City Trails and; the proximity to vehicular traffic; hidden and latent objects, insects, wildlife and holes. I recognize that participation in this activity on City of Wichita Falls property is a hazardous activity which is inherently dangerous. I agree to the extent possible to stay off of City streets while collecting trash; to be alert to traffic on, entering into this waiver and release exiting City Trails; to avoid grass cutting and construction activities on or nearby City trails; and to follow the instructions, terms, conditions and recommendations on the City of liability knowingly Wichita Falls’ informational handouts. I have voluntarily entered the event despite all known and voluntarily unknown risks of serious personal injury and/or death presented by preparing for and I confirm the participant is in good physical condition and is capable of participating in this programevent. In consideration of being permitted to enter City of Wichita Falls property, I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As suchdo herby release the City of Wichita Falls and their officers, my personal health insurance will be responsible for payment agents and employees from all claims, and causes of medical services and care action for any injuries sustained during the designated activity. In the event that medical attention is requiredall liability regarding, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damagesloss, claimsdamage, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part fromexpense that I may suffer, or otherwise that my next of kin may suffer which may result from my participation in connection with, the participantsCity of Wichita Falls’ activities. The participant understands they must abide by the Marymount University rules, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all timesAdopt-A-Trail Litter Cleanup Program. I hereby grant Marymount University unrestricted permission agree to use hold harmless the City of Wichita Falls and re-use photographic portraitstheir officers, editorialsagents and employees from liability for any all liability regarding, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all medialoss, and for any purpose allowed by law. This includesdamage, but is not limited toinjury or expense that I may suffer, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that my next of kin may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined above. I understand that the photographs taken by the staff or their designers of Marymount University will be included suffer during my participation in the Department filesCity of Wichita Falls’ Adopt-A-Trail Litter Cleanup Program. BY SIGNING THIS RELEASE AND WAIVER I agree the images, the transparencies AM INDICATING THAT I HAVE READ AND UNDERSTAND THIS RELEASE AND WAVIER AND AGREE TO ABIDE BY ITS PROVISIONS. Young Participant Parent of the images, and the copyright privileges of the images shall be the sole property of Marymount University. I acknowledge that I have read this document carefully and fully understand its contents. I agree that, should any provision or aspect of this agreement be found to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse or other person you would like Marymount University to contact in the event of an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Legal Guardian Name: Relationship to Minor: Phone#(s): Day: Night: CellSignature: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears on the next pages. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Date: Print Name: has the following ALLERGENS: (This form will be made available to camp staff.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Print Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity is being offered through Marymount University in ArlingtonI, VA. As used herein, “Marymount” includes Marymount University, the Department of Education and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6name/please print) I hereby certify I am a Padre Xxxxx Basketball Tournament / Practice Participant or the parent or legal guardian of (name/please print) (“Participant”) who is, and I acknowledge that I am entering into this waiver and release of liability knowingly and voluntarily and I confirm the participant is with my permission, a Participant in good physical condition and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As such, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participantPadre Serra Basketball Tournament / Practice. I hereby authorize Marymount University to contact me about give approval for the participantParticipant’s physical or mental health during the program if the University deems it advisable to do soenrollment and participation in this activity. I acknowledge and I have read the above Notice and understand and assume the risks associated with such participation. Participation in this activity is by choice and is completely voluntary. Accordingly, for myself as Participant, or in my capacity as parent or legal guardian for the Participant, and for my spouse, my heirs, assigns, related individuals and related entities, I do hereby release, waive, absolve, discharge, and agree to hold harmless Mount Xxxx University, its Board members, trustees, officers, employees, agents, and insurers (collectively, the “University Released Parties”) from and against any and all rights, claims, demands, causes of action, obligations, suits, liens, damages or liabilities of any kind and character whatsoever, whether known or unknown, suspected or claimed, which Participant shall or may have in the future against the University Released Parties arising out of, based on, related to or connected with As a Participant’s enrollment and participation in the Padre Serra Basketball Tournament / Practice, I also agree to indemnify and hold the University Released Parties harmless Marymount as defined above from the payment of any and all damagesjudgments, claimssettlements, liabilitiescosts, responsibilities disbursements and attorney fees that are associated with the University Released Parties having to defend or other expenses for personal injury investigate any claim, action or property damage resulting proceeding of any type whatsoever arising out of Participant’s enrollment or participation in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide by the Marymount University rules, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and reabove-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includesreferenced Padre Serra Basketball Tournament / Practice, but is not limited to, illustrationsclaims for breach of contract, promotionsnegligence, art workstrict liability, editorialor otherwise. This indemnification obligation and this Release and Waiver of Liability do not, advertising however, absolve the University Released Parties from any liability, damages, costs, disbursements and tradeattorney fees incurred due to their intentional or reckless conduct. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined above. I fully understand that if any fact with respect to which this Release and Waiver of Liability is executed is found hereafter to be other than or different from the photographs taken fact in that connection now believed by me to be true, I expressly accept and assume the staff or their designers risk of Marymount University will be included suck possible difference in the Department files. I fact and agree the images, the transparencies that this Release and Waiver of the images, and the copyright privileges of the images Liability shall be the sole property of Marymount University. I acknowledge that I have read this document carefully and fully understand its contents. I agree that, should any provision or aspect of this agreement be found to be unenforceable, that all remaining provisions of the agreement will remain effective notwithstanding such difference in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse or other person you would like Marymount University to contact in the event of an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears on the next pages. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Name: has the following ALLERGENS: (This form will be made available to camp stafffacts.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity is being offered through Marymount University in Arlington, VA. As used herein, “Marymount” includes Marymount University, the Department of Education and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II and Literacy Lab Date(s): July 6 12 – 1723, 2020 2021 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am the parent or guardian of , and I acknowledge that I am entering into this waiver and release of liability knowingly and voluntarily and I confirm the participant is in good physical condition and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As such, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide by the Marymount University rules, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and re-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined above. I understand that the photographs taken by the staff or their designers of Marymount University will be included in the Department files. I agree the images, the transparencies of the images, and the copyright privileges of the images shall be the sole property of Marymount University. I acknowledge that I have read this document carefully and fully understand its contents. I agree that, should any provision or aspect of this agreement be found to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse or other person you would like Marymount University to contact in the event of an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears on the next pages. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Name: has the following ALLERGENS: (This form will be made available to camp staff.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity Alternative Break Experience (ABE) Service Trip Group Agreement and Release and Waiver of Liability is being offered through Marymount University in Arlington, VA. As used herein, “Marymount” includes Marymount University, the Department of Education executed and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am the parent or guardian of , and I acknowledge that I am entering into this waiver and release of liability knowingly and voluntarily and I confirm the participant is in good physical condition and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As such, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide given by the Marymount undersigned to Saint John’s University rules(collectively “St. John’s”) and the College of Saint Benedict, policies and procedures, in addition to any specific rules that may apply to the specified activity and will follow the direction of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and rea Minnesota non-use photographic portraits, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined aboveprofit corporation (“CSB”). I understand that the photographs taken Alternative Break Experience program that is sponsored by the staff College of St. Benedict Campus Ministry department is a service, educational and social justice opportunity. I am freely choosing to go on this trip, and within reason, I am willing to do the service work that is asked of me by the experience. As an adult, I agree to take responsibility for my behavior and safety during the course of this trip, including acknowledgment of my own limitations. I will act consciously and maturely. I will respect and care for my fellow volunteers, the site leaders, and those for whom I am offering my service. I will contribute my efforts toward the good of the whole group and the complete experience that the ABE program offers. Safety is a primary concern of the ABE program. The poverty and injustice we seek to address through service can lead to unsafe situations. I understand that the activities may be hazardous to myself and may include, but are not limited to: construction, loading, unloading, and transportation to and from sites. I recognize that the activities may, in some situations, be inherently dangerous. I will cooperate with the ABE co-leaders and host site leaders to promote a safe environment and understand that some aspects of the trip may be changed or canceled to address safety. I will respect the authority and responsibility of the co-leaders and will abide by their designers decisions. In keeping with that respect, I will speak up on my behalf or the behalf of Marymount University others when I disagree with the way in which important matters are being handled. In full recognition and appreciation of the dangers and hazards inherent in participation in the ABE program, signing this release discharges CSB/SJU from any liability or claim that I may have against CSB/SJU with respect to any bodily injury, personal injury, illness, death or property damage that may result from an alternative break trip, whether caused by the negligence of CSB/SJU or its trip facilitators. I hereby agree to assume all the risks and responsibilities surrounding my participation in these activities or any other activities undertaken as an adjunct thereto. Though I may be of legal age to drink alcohol, I agree to abide by the ABE policy that prohibits the consumption of alcohol. This policy is established as a way to enhance our commitment to service, focusing our energy on what’s important and essential throughout the service experience. In addition, this policy is enforced out of respect for the people we visit for whom alcohol is an expensive luxury and one that might be abused. Additionally, it is also out of respect for under-age participants who would otherwise be excluded from alcohol- related activities. I will uphold the law, and take full responsibility for my actions during the course of this service trip including the use of any controlled substances. If I break the law or break ABE policies, I understand I may be sent home immediately at my own expense and I will be included subject to the laws and regulations of the host site and the College of Saint Benedict and Saint John’s University. Except as otherwise agreed by the College of St. Benedict/St. John’s University in writing, I hereby release and forever discharge the Department filesCollege of St. Benedict/ St. John’s University from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with my participation. I agree also understand that the imagesCollege of St. Benedict/St. John’s University does not carry or maintain health, the transparencies medical, or disability insurance coverage for any participant. I am expected and encouraged to obtain my own medical or health insurance coverage. I understand that there may be health-related risks in connection to my trip. If I am a member of the images, and the copyright privileges of the images shall be the sole property of Marymount University. an international trip I acknowledge that I have read this document carefully and fully understand its contentsbeen advised by the ABE staff and/or co-leaders to seek medical advice in regards to immunizations pertinent to my host country. I agree that, should any provision or aspect understand that costs of these immunizations are my own. I take full responsibility for meeting the financial responsibilities of this agreement be found trip including making payments by the set deadlines. CSB/SJU does not assume any responsibility for or obligation to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse provide financial assistance or other person you would like Marymount University assistance, including but not limited to contact medical, health or disability insurance in the event of injury or illness. I hereby expressively and specifically assume the risk of property damage, injury, death or illness resulting from my activities as an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears Alternative Break Experience program participant. ABE trips begin on the next pagesfirst day of travel and end on the last scheduled day of travel– upon return to Minnesota/the CSB/SJU campuses. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS I will travel to the site with the group and return with my group. I hereby defend, hold harmless, indemnify, release, and forever discharge CSB/SJU, Campus Ministry offices, trip facilitators and their successors and assigns from and against any and all claims, demands, actions, causes of action, damage to personal property, personal injury, death, arrest, or criminal or civil prosecution (including legal fees, fines, court costs or penalties) which may result from my volunteer assignments, activities, transportation, or work experiences on an Alternative Break Experience. By signing below, I acknowledge my agreement with all of the statements on this Group Agreement and Release and Waiver of Liability. Trip Name: has the following ALLERGENS: (This form will be made available to camp staff.) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code of one parent: As needed Allergist/Doctor: Phone # of Doctor: Hospital of Choice: Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:

RELEASE AND WAIVER OF LIABILITY. This activity Alternative Break Experience (ABE) Service Trip Group Agreement and Release and Waiver of Liability is being offered through Marymount University in Arlington, VA. As used herein, “Marymount” includes Marymount University, the Department of Education executed and their employees, agents, officers, directors, and affiliates. Activity: 3E: Explore, Enrich, Enjoy Summer Camp Session I and Session II Date(s): July 6 – 17, 2020 from 9:00am to 4:00pm (before and after camp hours also provided 8-6) I hereby certify I am the parent or guardian of , and I acknowledge that I am entering into this waiver and release of liability knowingly and voluntarily and I confirm the participant is in good physical condition and is capable of participating in this program. I understand that Marymount does not provide health insurance for individuals participating in activities made available or sponsored by Marymount. As such, my personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity. In the event that medical attention is required, I understand that every attempt will be made to contact me at the emergency number(s) provided. If contact with me is not possible, I give permission for qualified emergency care personnel to hospitalize, secure treatment for, and take whatever medical action(s) necessary to treat the participant. I hereby authorize Marymount University to contact me about the participant’s physical or mental health during the program if the University deems it advisable to do so. I hereby release, waive, indemnify and hold harmless Marymount as defined above from any and all damages, claims, liabilities, responsibilities or other expenses for personal injury or property damage resulting in whole or in part from, or otherwise in connection with, the participants’ activities. The participant understands they must abide given by the Marymount University rules, policies and procedures, in addition to any specific rules that may apply undersigned to the specified activity Order of Saint Benedict, a Minnesota non-profit corporation and will follow its operating division, Saint John’s University (collectively “St. John’s”) and the direction College of the group leader(s) at all times. I hereby grant Marymount University unrestricted permission to use and re-use photographic portraitsSaint Benedict, editorials, video, digital or film images, or any pictures taken of myself, or my child, individually or in conjunction with other photographs, in any printed or video graphic matter, in any and all media, and for any purpose allowed by law. This includes, but is not limited to, illustrations, promotions, art work, editorial, advertising and trade. I hereby waive any right to inspect or approve the finished product or products that may be used in connection with the above mentioned images. I hereby release Marymount University, Marymount University, their legal representatives, and all people acting under their permission or authority, from any liability in connection with the use of the images as outlined abovea Minnesota non- profit corporation (“CSB”). I understand that the photographs taken Alternative Break Experience program that is sponsored by the staff College of St. Benedict/St. John’s University Campus Ministry departments is a service, educational and social justice opportunity. I am freely choosing to go on this trip, and within reason, I am willing to do the service work that is asked of me by the experience. As an adult, I agree to take responsibility for my behavior and safety during the course of this trip, including acknowledgment of my own limitations. I will act consciously and maturely. I will respect and care for my fellow volunteers, the site leaders, and those for whom I am offering my service. I will contribute my efforts toward the good of the whole group and the complete experience that the ABE program offers. Safety is a primary concern of the ABE program. The poverty and injustice we seek to address through service can lead to unsafe situations. I understand that the activities may be hazardous to myself and may include, but are not limited to: construction, loading, unloading, and transportation to and from sites. I recognize that the activities may, in some situations, be inherently dangerous. I will cooperate with the ABE co-leaders and host site leaders to promote a safe environment and understand that some aspects of the trip may be changed or canceled to address safety. I will respect the authority and responsibility of the co-leaders and will abide by their designers decisions. In keeping with that respect, I will speak up on my behalf or the behalf of Marymount University others when I disagree with the way in which important matters are being handled. In full recognition and appreciation of the dangers and hazards inherent in participation in the ABE program, signing this release discharges CSB/SJU from any liability or claim that I may have against CSB/SJU with respect to any bodily injury, personal injury, illness, death or property damage that may result from an Alternative Spring break trip, whether caused by the negligence of CSB/SJU or its trip facilitators. I hereby agree to assume all the risks and responsibilities surrounding my participation in these activities or any other activities undertaken as an adjunct thereto. Though I may be of legal age to drink alcohol, I agree to abide by the ABE policy that prohibits the consumption of alcohol. This policy is established as a way to enhance our commitment to service, focusing our energy on what’s important and essential throughout the service experience. In addition, this policy is enforced out of respect for the people we visit for whom alcohol is an expensive luxury and one that might be abused. Additionally, it is also out of respect for under-age participants who would otherwise be excluded from alcohol-related activities. I will uphold the law, and take full responsibility for my actions during the course of this service trip including the use of any controlled substances. If I break the law or break ABE policies, I understand I may be sent home immediately at my own expense and I will be included subject to the laws and regulations of the host site and the College of Saint Benedict and Saint John’s University. Except as otherwise agreed by the College of St. Benedict/St. John’s University in writing, I hereby release and forever discharge the Department filesCollege of St. Benedict/ St. John’s University from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with my participation. I agree also understand that the imagesCollege of St. Benedict/St. John’s University does not carry or maintain health, the transparencies medical, or disability insurance coverage for any participant. I am expected and encouraged to obtain my own medical or health insurance coverage. I understand that there may be health-related risks in connection to my trip. If I am a member of the images, and the copyright privileges of the images shall be the sole property of Marymount University. an international trip I acknowledge that I have read this document carefully and fully understand its contentsbeen advised by the ABE staff and/or co-leaders to seek medical advice in regards to immunizations pertinent to my host country. I agree that, should any provision or aspect understand that costs of these immunizations are my own. I take full responsibility for meeting the financial responsibilities of this agreement be found trip including making payments by the set deadlines. CSB/SJU does not assume any responsibility for or obligation to be unenforceable, that all remaining provisions of the agreement will remain in full force and effect. EMERGENCY CONTACT: Please give the name of parent, guardian, spouse provide financial assistance or other person you would like Marymount University assistance, including but not limited to contact medical, health or disability insurance in the event of injury or illness. I hereby expressively and specifically assume the risk of property damage, injury, death or illness resulting from my activities as an emergency: Name: Relationship: Address: Phone#(s): Day: Night: Cell: Email: PAYMENT INFORMATION: $350.00 Online PARENT/GUARDIAN WAIVER FOR MINORS Participant Printed Name: Nickname/Preferred Name (if any): Participant Address: City: State: Zip: Parent/Guardian Name: Relationship to Minor: Phone#(s): Day: Night: Cell: Signature: Date: IF YOUR CHILD HAS AN ALLERGEN that we need to know about, then please fill out the extensive 3E allergen form that appears Alternative Break Experience program participant. ABE trips end on the next pageslast scheduled day of the trip – upon return to the CSB/SJU campuses. ALLERGEN FORM ONLY FOR CAMPERS WITH ALLERGENS Name: has I will return with my group unless prior arrangements have been made. ABE and CSB/SJU are also not responsible for any student electing to remain at a site, or to travel to another destination after the following ALLERGENS: trip. I hereby defend, hold harmless, indemnify, release, and forever discharge CSB/SJU, Campus Ministry offices, trip facilitators and their successors and assigns from and against any and all claims, demands, actions, causes of action, damage to personal property, personal injury, death, arrest, or criminal or civil prosecution (This form will be made available to camp staff.including legal fees, fines, court costs or penalties) DOB: / / Student Age: Parent/Guardian 1 information as needed: – Home: Work: Cell: Parent/Guardian 2: – Home: Work: Cell: Or call Emergency Contact if unable to reach Parent/Guardian: Name: Phone: Relation: Address/Zip Code which may result from my volunteer assignments, activities, transportation, or work experiences on an Alternative Break Experience. By signing below, I acknowledge my agreement with all of one parent: As needed Allergist/Doctor: Phone # the statements on this Group Agreement and Release and Waiver of Doctor: Hospital of Choice: Liability. Name Signature Date of student’s last allergic episode? / / or Never had an allergic episode Has student been hospitalized for an allergic episode? 1 Yes 1 No T-shirt Size Name Signature Date / / What happened? Diagnosed by skin/blood testing? 1 Yes 1 No T-shirt Size Name Signature Date / / Does your child react when they eat the above allergen? 1 Yes 1 No Type of reaction:T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size Name Signature Date T-shirt Size