Eastern Kentucky University Waiver of Liability, Assumption of Risk, and Indemnity Agreement

THIS IS A LEGALLY BINDING RELEASE, WAIVER, INDEMNIFICATION OF LIABILITY, AND EXPRESS ASSUMPTION OF RISK.

***Please read it carefully, fill in all blanks and initial each paragraph before signing ***

A parent/guardian must complete (initial and sign) this form if student is under age 18.

I, {main_name}, hereby affirm that I have read this document in its entirety. By my signature below and by my initialing each paragraph, I agree to each and every term and condition of this document.

I UNDERSTAND THAT PARTICIPATION IN Upward Bound 2024-25 academic year activities (hereafter referred to as “Event”), which are further detailed below and involve bus transportation; in-state and out of state cultural experiences; voluntary excursions; and participation in academic events on Eastern Kentucky University’s campus, CARRIES WITH IT CERTAIN INHERENT RISKS AND DANGERS. THESE RISKS INCLUDE, BUT ARE NOT LIMITED TO: PERSONAL DAMAGE, INJURY, PANDEMIC EXPOSURE, PARALYSIS, LOSS, DROWNING, DEATH, OR PROPERTY DAMAGE OR LOSS. I understand that the aforementioned risks are described by way of example only, and there are numerous other risks inherent in the Event to which I may be exposed. In the event of possible injury, I give permission for Eastern Kentucky University (University) to authorize the administration of medical care, and I understand that I will be solely responsible for any financial costs associated with such medical care.

IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN ANY WAY IN Upward Bound activities for the 2024-2025 school year: I, on behalf of myself and anyone claiming interest through me, DO HEREBY INTENTIONALLY, KNOWINGLY, AND VOLUNTARILY RELEASE, WAIVE, DISCHARGE, INDEMNIFY, AND AGREE TO HOLD HARMLESS the University and all its employees, regents, volunteers, and representatives FROM ANY AND ALL CLAIMS, ACTIONS, SUITS, PROCEDURES, COSTS, EXPENSES, DAMAGES, AND LIABILITIES (INCLUDING ATTORNEY FEES AND COSTS) resulting from my involvement in the Event, whether such damage, injury, illness, loss, or death results from NEGLIGENCE or some other cause, and agree to reimburse any such expenses incurred by the University. I understand that at times participants may be together in groups that are not under direct supervision of Upward Bound.

I understand that the University in no way represents, or acts as an agent for, any third party trip organizer, transportation carrier, hotel, or other suppliers of service during the Event. I understand and agree that the University is not responsible for losses or expenses due to sickness, weather, strikes, hostilities, wars, natural disasters, or other such causes or disruptions. Further, the University is not responsible for any disruption of travel arrangements, or any consequent additional expenses that may be incurred therefrom.

I have read and understand that this release, waiver, indemnification of liability, and express assumption of risk, and sign this document on behalf of myself and anyone claiming interest through me with the intent to release, waive, and indemnify EKU and Released Parties from all liability connected with my participation in the Event (including but not limited to the negligence of EKU and Released Parties, whether passive or active) and to personally assume all risks and dangers inherent in the Event to which I may be exposed. I understand and agree that the Event will not provide any insurance or benefits, including but not limited to workman’s compensation benefits, on my behalf.

I HEREBY ASSERT THAT MY PARTICIPATION IN THE EVENT IS VOLUNTARY AND THAT I KNOWINGLY ASSUME ALL SUCH RISKS AND DANGERS. I acknowledge that the University has not required, coerced, or encouraged me to participate in the Event. I understand that I signed this document as my own free act and deed; apart from the foregoing written statement, no oral representations, statements, or inducements have been made.

I further agree that this document will be interpreted in accordance with the laws of the Commonwealth of Kentucky. If any term or provision of this document shall be held illegal, unenforceable or in conflict with any law governing this document, the validity of the remaining portions shall not be affected.