General Assumption Of Risk & Release Of Liability printable pdf download

MARICOPA COUNTY COMMUNITY COLLEGE DISTRICT

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GENERAL ASSUMPTION OF RISK & RELEASE OF LIABILITY

Caution: This is a release of legal rights. Read and understand it before signing.

The Maricopa County Community College District is a public educational institution. References to College

("College") include all of the Colleges within the Maricopa County Community College District ("MCCCD"), its

officers, officials, employees, volunteers, students, agents, and assigns.

I ______________________________, freely choose to participate in the ______________________ (henceforth

referred to as the “Program”). In consideration of my participation in this Program, I agree as follows:

RISKS INVOLVED IN PROGRAM: (Specific dangers endemic in this Program’s activity.)

HEALTH AND SAFETY: I have been advised to consult with a medical doctor with regard to my personal

medical needs.

I state that there are no health-related reasons or problems that preclude or restrict my

participation in this Program. I have obtained the required immunizations, if any.

I recognize that College is not obligated to attend to any of my medical or medication needs, and I assume all risk

and responsibility therefore. In case of a medical emergency occurring during my participation in this Program, I

authorize in advance the representative of the College to secure whatever treatment is necessary, including the

administration of an anesthetic and surgery. College may (but is not obligated to) take any actions it considers to

be warranted under the circumstances regarding my health and safety. Such actions do not create a special

relationship between the MCCCD and me. I release the MCCCD, its officers, officials, employees, volunteers,

students, agents and assigns from all liability for any bodily injury or damage I sustain as a result of any medical

care that I receive resulting from my participation in Program, as well as any medical treatment decision or

recommendation made by an employee or agent of the MCCCD

I agree to pay all expenses relating thereto and

release College from any liability for any actions.

ASSUMPTION OF RISK AND RELEASE OF LIABILITY: Knowing the risks described above, and in

voluntary consideration of being permitted to participate in the Program, I agree to release, indemnify, and defend

College and their officials, officers, employees, agents, volunteers, sponsors, and students from and against any

claim which I, the participant, my parents or legal guardian or any other person may have for any losses, damages

or injuries arising out of or in connection with my participation in this Program.

SIGNATURE: I indicate that by my signature below that I have read the terms and conditions of participation

and agree to abide by them. I have carefully read this Release Form and acknowledge that I understand it. No

representation, statements, or inducements, oral or written, apart from the foregoing written statement, have been

made. This Release Form shall be governed by the laws of the State of Arizona which shall be the forum for any

lawsuits filed under or incident to this Release Form or to the Program. If any portion of this Release Form is

held invalid, the rest of the document shall continue in full force and effect.

Signature of Program Participant

Date

Signature of Parent or Legal Guardian (if student is a minor)

Date

MC-AORROL-GEN (12/04)

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General Assumption Of Risk & Release Of Liability