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LEHIGH UNIVERSITY
WAIVER and RELEASE OF LIABILITY FORM for ACTIVITIES OFF CAMPUS

This is a legal and binding agreement which, when signed, will permanently limit your ability to recover from the parties indicated below for injuries or losses you may sustain as a result of participation in off-campus activities.

Lehigh University is a non-profit educational institution. References to Lehigh University include Lehigh University, its trustees, officers, faculty, employees, volunteer workers, students, Student Government Association and participating organizations, agents and assigns, and anyone else participating in the off-campus activities described below.

I freely choose to participate in an off-campus program of my own selection (referred to as the Trip).

I understand that Lehigh University is not an agent of, and has no responsibility for, any third party including without limitation any sponsor which may provide any services including food, lodging, travel, or any equipment associated with the Trip. Lehigh University has not reviewed the qualifications of the Trip organizer or sponsor. Lehigh University does not endorse the program in any way, including the safety of the program, the quality of the program or any services the program may contract for.

I understand that participating in any activity is an acceptance of some risk of injury. I agree that my safety is primarily dependent upon my taking proper care of myself. I agree to evaluate the qualifications of the trip organizer or sponsor and any contracted services they may provide. I agree to inform myself about the potential dangers of the area I am traveling to and precautions which should be taken, including reviewing the State Department Consular Travel Information at http://www.travel.state.gov and the Centers for Disease Control Travelers Information at http://www.cdc.gov/travel/ for health and immunization information, and any other information that may be provided to me by the Trip organizer or by Lehigh University.

I agree to inform my parent(s) or guardian(s) that I will be participating in this Trip.

Despite precautions, accidents and injuries can and will occur. I understand that travel and other activities the Trip may undertake may be potentially dangerous and that I may be injured and/or lose or damage personal property as a result of participation in the Trip. Therefore I, ASSUME ALL RISKS RELATED TO THE ACTIVITIES including but not limited to:

  • Death, injury or illness from accidents of any nature whatsoever, including but not limited to bodily injury of any nature whether severe or not, temporary or permanent, including death, which may occur as a result of participating in an activity or contact with physical surroundings, animals, insects, plants or other persons
  • Death, injury or loss of or damage to personal belongings arising from travel by car, bus, van or any other means.
  • Death, injury or illness including food poisoning arising from the provision of food or beverage by restaurants or other service providers.
  • Death, injury or illness from deliberate acts of violence including criminal activities, political unrest, war, rebellion, hostage taking, riots, or any other actions by third parties.
  • Theft or loss of my personal property while in transit or during Trip activities.
  • Natural disaster or other disturbances, and alteration or cancellation of Trip activities due to such causes.

I further acknowledge that the above list is not inclusive of all possible risks associated with the Trip and that the above list in no way limits the extent or reach of this release and covenant not to sue. I further understand that participating in this Trip is an acceptance of risk of injury or death.

Medical Treatment Authorization

I authorize Lehigh University to act on my behalf in any medical emergency.


Release from Liability, Indemnification Agreement and Covenant Not to Sue

I the undersigned, to the fullest extent permitted by law, agree to forever release and on behalf of myself, my spouse, heirs, representatives, executors, administrators and assigns, HEREBY DO FOREVER RELEASE Lehigh University from any cause of action, claims, or demands of any nature whatsoever, including but not limited to a claim of negligence which I or my spouse, heirs, representatives, executors, administrators and assigns may now have, or have in the future against Lehigh University on account of personal injury, bodily injury, property damage, death or accident of any kind, arising out of or in any way related to my participation in the Trip and/or the use of facilities, equipment, or services in association with the Trip howsoever the injury is caused, whether by the negligence of Lehigh University or otherwise.

I, the undersigned, COVENANT NOT TO SUE and agree to INDEMNIFY AND HOLD HARMLESS Lehigh University from any and all causes of action, claims, demands, losses or costs of any nature whatsoever arising out of or in any way relating to my participation in the Trip and my use of facilities, equipment, or services in association with the Trip.

I hereby certify that I have full knowledge of the nature and extent of the risks inherent in the Trip and the use of facilities, equipment, or services in association with the Trip, and that I am voluntarily assuming all risks, whether known or unknown.

I understand that I will be solely responsible for any loss or damage, including death, which I sustain or cause, whether in whole or in part, while participating in the Trip and my use of facilities, equipment, or services in association with the Trip, and that by this agreement I am relieving Lehigh University of any and all liability for such loss, damage or death.

My signature below indicates that I have read, understood, and freely signed this agreement, which shall take effect as a sealed instrument. I further certify that I am otherwise legally competent to sign this agreement. I further understand that the terms of this agreement are legally binding and I certify that I am signing this agreement after having carefully read and understood the same, of my own free will. This agreement is made in sole consideration of Lehigh University supporting my participation in the Trip and my use of facilities, equipment, or services associated with the Trip.

This agreement shall be construed and enforced in accordance with the laws of the Commonwealth of Pennsylvania, and I consent to the jurisdiction of this state. I expressly agree that this waiver and release is intended to be as broad and inclusive as permitted under the laws of the Commonwealth of Pennsylvania, that if any portion hereof is held invalid, it is agreed that the remainder of it shall, notwithstanding, continue in full legal force and effect.

- IMPORTANT –
READ ENTIRE AGREEMENT BEFORE SIGNING

Today's Datez; April 19, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Age:
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Age:
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Age:
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Age:
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Age:
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Age:
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Age:
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Age:
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Age:
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Age:
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Event

What event is this waiver for?

What organization is hosting the event?

What is the date of the event?
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Age:
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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