UNIVERSITY OF LOUISVILLE and Its Affiliates (“University”) PARTICIPATION & RELEASE FORM
DEPARTMENT: SAC Special Programs, Welcome Week
UNIVERSITY CONTACT: Jessica Combess
PHONE NUMBER: (502) 852-0321
ACTIVITIES INVOLVED IN PROGRAM PARTICIPATION:
IF TRANSPORTATION TO THE PROGRAM/FIELD TRIP SITE IS PROVIDED BY THE UNIVERSITY, PARTICIPANTS MAY NOT UTILIZE A MEANS OF TRANSPORTATION INDEPENDENT OF THAT WHICH IS PROVIDED. PARTICIPANTS SHOULD ASSEMBLE AT THE PROGRAM/FIELD TRIP SITE AT THE APPOINTED TIME.
- The undersigned voluntarily and willingly agrees, and is able to participate in the above-described program and in all activities included in and required by the program.
- The undersigned acknowledges that if this field trip/program is for academic credit, the University has offered an alternative means of receiving academic credit in lieu of participating in the field study.
- The undersigned agrees to assume all risk of accident or damage to his or her person or property as a result of the participation in the program and in the activities included in and required by the program, including transportation to and from the program site.
- The undersigned authorizes the University and its agents to obtain medical care for the undersigned in the event that it is determined that in their opinion the undersigned is in need of immediate emergency medical attention while the undersigned is participating in the program. If such medical care is sought, the undersigned authorizes any medical care facility or physician selected by the University to perform whatever medical services are deemed necessary to preserve the undersigned's life, health, and well-being. The undersigned agrees to be responsible for and to indemnify and hold harmless the University and any of its agents and employees for the payment of all costs and expenses resulting from any such medical care, hospitalization, and medical services for the undersigned.
- The undersigned agrees to remain under the supervision of and to comply with university policies and specific program rules as well as any instructions given by the University and its agents at all times during the program.
- The undersigned does hereby authorize the University and its representatives, and representatives of the program, to release the name and any relevant information about the undersigned as deemed appropriate.
- The undersigned releases the University and its officers, directors, agents, servants, and employees from any and all actions, causes of action, demands, damages, expenses, attorney fees, and claims and counterclaims of any kind or nature, including any claims of negligence, arising out of or in any way connected with (1) the participation of the undersigned in the program and in the activities included in and required by the program, including transportation to and from the program site; (2) the decisions or actions of the University in seeking and obtaining, or in failing to seek and obtain, the above-authorized immediate emergency medical attention; and (3) any failure of the undersigned to remain under the supervision of and to comply with any instructions given by the University and its employees or agents during the program.
The undersigned certifies that he/she has read and understands the above University Program Participation Release Form, and that he/she signs this form voluntarily.
PHOTO / VIDEO RELEASE & CONSENT FORM
University of Louisville
Imaging, Television & New Media
I authorize the University of Louisville to photograph or record my name, likeness, voice and performance without payment or other compensation.
I release all claim to audio and video recordings or photographs of this performance and assign all rights to these images or recordings to the University of Louisville.
I understand use of these images and recordings may include educational materials, educational broadcasts and web sites or promotion of the University of Louisville.
My assignment of these rights is not limited to any specific time period or purpose.
I warrant that all material furnished by me is either my own original work or work for which I have obtained copyright permission and full authority to use for this purpose.
I agree to all of the above on behalf of myself, my minor child, other family member or person for whom I have legal responsibility.