Release and Waiver of Liability
Read the statement below. Both participant and parent signatures are required
below.
For, and in consideration of, the agreement of the University of Arkansas to permit me to voluntarily
participate in a program to be hosted by the University of Arkansas College of Engineering. I, hereby, generally and forever release and discharge without limitation, and agree not to sue the University of Arkansas and/or its respective officers, employees and agents, from and against any and all manner of claims, causes of action, or liability which I may have now or
at any time in the future against the University of Arkansas, and/or its respective officers, employeesand agents, including without limitation, any faculty or staff members assisting with the program,which may arise out of or relate to any injury (including, but not limited to death), loss, damage or
harm of any kind which may result or may happen to me during the period while I am participating in the program, including any injury (including, but not limited to death), loss, damage or
harm which may result from the negligence of the University of Arkansas and/or its respective
officers, employees and/or agents.
I further agree to indemnify, defend, protect, and hold harmless the University of Arkansas and/or its
respective officers, employees, and agents, from and against any and all manner of claims, causes
of action, or liability, arising out of or relating to any accident, injury or damage, including, but not
limited to death, to me which may occur during my voluntary participation in the program.
I further state that I will abide by any and all rules and regulations set forth by the University of
Arkansas. I further acknowledge and agree that my intentional or inadvertent failure to abide by
these rules may result in my immediate removal from the program without notice.
I assume all risks inherent in the planned activities during the program. The University of Arkansas will not be responsible for monitoring participant’s activities during such free time and is hereby released from any liability. I have notice of all the risks inherent in such activities including, but not limited to, risks involving (i) athletic, sporting, and exercise activities involving
rigorous physical activity or physical contact; and (ii) swimming; and (iii) driving/riding in vehicles. I understand that activities may result in serious injuries or death, including but not limited to burns, blindness, drowning, loss of hearing, head injuries, neck injuries, spine injuries, and broken bones,
and can result in complete or partial paralysis, brain damage, serious injury to internal organs, serious injury to my musculoskeletal system or death.
I will maintain all medical and health insurance which I deem necessary to cover all risks of any kind
in regard to program activities.
I will at all times wear and use all safety equipment and follow all safety procedures as directed by
the University of Arkansas. I agree that I will not utilize
any equipment, materials or facilities unless I fully understand the safe and proper use of such
equipment, materials and facilities.
I agree not to take part in any activities that would represent a danger to me due to my health or
physical condition, regardless of whether I have disclosed such condition to any officer, agent or
employee of the University of Arkansas. I agree that if I do undertake any such activities, I do so
solely at my own risk and peril.
This Release and Waiver of Liability may be in addition to and does not revoke or modify any other
agreement or release which I may execute in connection with the Engineering program.
This Release and Waiver of Liability shall be construed and enforced in accordance with the laws of
the State of Arkansas, without regard to its choice of law principles.
I HAVE CAREFULLY READ THIS RELEASE AND WAIVER OF LIABILITY AND FULLY
UNDERSTAND ITS CONTENTS. I ACKNOWLEDGE AND AGREE THAT THIS RELEASE AND
WAIVER OF LIABILITY SHALL BE BINDING UPON MY SURVIVORS, HEIRS, SUCCESSORS,
AND ASSIGNS. I AM AWARE THAT THIS RELEASE AND WAIVER OF LIABILITY IS A RELEASE
OF LIABILITY, INCLUDING BUT NOT LIMITED TO, LIABILITY FOR NEGLIGENCE, AND
AN INDEMNIFICATION AGREEMENT, AND I SIGN IT OF MY OWN FREE WILL AS A
VOLUNTARY CONDITION OF BEING PERMITTED TO TAKE PART IN THE ENGINEERING ACTIVITIES ON AND OFF OF THE UNIVERSITY OF ARKANSAS CAMPUS.
I understand that entering my name below constitutes a legal signature confirming that I
acknowledge and agree to the above Release and Waiver of Liability.