Mainebound Course Release And Assumption Of Risk Form printable pdf download

7/30/07

UNIVERSITY OF MAINE

DIVISION OF STUDENT AFFAIRS

CAMPUS RECREATION- MAINE BOUND COURSES

MAINEBOUND COURSE RELEASE AND ASSUMPTION OF RISK

I, __________________________________________________________________, of

(Name)

____________________________________________________________________

(Full Mailing Address)

being ____ years of age (having been born on ____/____/____), acknowledge, declare

and agree as follows:

That I have voluntarily agreed to participate in the ________________________,

(the “Program”) from _________, 20____ to _________, 20____, and in consideration of

being permitted to participate in the Program, do voluntarily execute this “Release and

Assumption of Risk” on behalf of my self, my heirs and next-of-kin, my personal

representatives and my estate.

That I have been fully informed of the nature, scope and demands of the Program,

and I understand that the Program may include activities which could be dangerous to me

and other participants and which could cause property damage, bodily injury and/or

death.

*See below for specific risks and dangers of the Program.

That the University of Maine System and its University of Maine (hereinafter

referred to as the “University”) have informed me that there may be dangers and hazards

inherent to participants in the Program because of the activities involved, and that I

personally recognize and appreciate that such dangers and hazards exist. I accept and

assume full responsibility for all harm and injury, of every nature, including death, which

may occur to me or which I may suffer or cause to others, and for all damages or loss to

any personal property owned by me or damaged by me, while I am participating in the

Program and during all travel and transportation, and, in furtherance thereof, I agree to

indemnify, hold harmless and release the University, its Trustees, faculty, employees,

volunteers and agents, from and against any and all claims, demands, actions or causes of

action, on account of damage or loss to my personal property, my personal injury or

death, or the bodily injury, death or damage to personal property of others caused by me,

which may occur or result directly or indirectly from my participation in the Program and

not as a direct result of any negligent act of the University, its Trustees, faculty,

employees, volunteers or agents.

I declare that I am able to physically withstand and cope with the indicated rigors

of the Program with or without a reasonable accommodation. If an accommodation is

needed, I will contact the Assistant Director for MaineBound at 581-1794.

Mainebound Course Release And Assumption Of Risk Form