ࡱ> SURQ bjbj Dveivei >>>>>RRR8R;$ >>>:::^>>::::pM &(: 0;:=!N^=!:=!>:l^:wL;=!X : BRYN MAWR COLLEGE, HAVERFORD COLLEGE, AND SWARTHMORE COLLEGE RELEASE FOR STUDENTS ENGAGING IN CIVIC ENGAGEMENT ACTIVITIES Name of Person Giving Release: (Student's name please print) Releasees: 1) 91ֱ, Haverford College, and Swarthmore College, their agents and employees including Boards of Trustees, Administration, Faculty, Staff, and Students. Release: I release and give up all claims, including claims for negligence I now have or may have in the future against Releasees arising out of my participation in the following activity: ______________________________________ I also understand that the activity set forth above is undertaken by me on a completely voluntary basis. I make this decision by choice and my participation in this activity is undertaken knowing that risks may be involved. These risks include, but are not limited to, arrest, incarceration, and resulting criminal record, property loss or damage and physical or emotional injury, temporary or permanent, and death. I voluntarily assume the risks of these dangers by choosing to participate in the activity. I understand Releasees do not assume any risk or liability due to my participation in this activity. I understand this Release applies to all claims for property loss, injury or illness, or death or any other damages suffered by me, now or in the future, whether suffered in traveling to the activity or during the activity itself. I further state that I am at least eighteen (18) years of age and fully competent to sign this Release; and that I execute this Release in consideration of the opportunity to participate in the activity granted by Releasees, fully intending to be bound by it. I further agree that this Release shall be construed in accordance with the laws of the Commonwealth of Pennsylvania. If any term or provision of this Release shall be held illegal, unenforceable, or in conflict with any law governing this Release, the validity of the remaining portions shall not be affected thereby. Binding: This Release binds me, my heirs and personal representatives. I understand that it benefits the heirs, personal representatives or successors and assigns of Releasees. Signing: Before signing my name to this Release, I state that: 1) I have read it, 2) I understand it and know that I am giving up important rights, 3) I intend to be legally bound by it. Student's Signature (18 years of age or older) Date Date of Birth: Please return this completed waiver form to: 91ֱ Career & Civic Engagement Center Student Life & Wellness Building (610) 526 6591 ** Any student seeking reimbursement for travel expenses to and/or from this event must submit this completed form PRIOR to the event and any related request for reimbursement. **     Eyz{|}y R x y z <Qx\*+;[]^_鶶hLCJOJQJh^+CJOJQJh!v8CJOJQJh^CJOJQJhhCJOJQJhmFCJOJQJh;)F>*CJOJQJh;)FCJOJQJ h^5h^h;)F@Ez{|}y y z $^a$ $^`a$$`^``a$gd{ $`^``a$$a$\*+]^_$a$$^a$ $`^``a$`dŻh;)Fjh;)FUhjhUh^h!v85CJh^h^5CJOJQJhL5CJOJQJh^h!v85CJOJQJh!v8CJOJQJhLCJOJQJ$a$1$ $:@&1$a$B 0 000P/ =!"#$% Dpx2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@66666_HmH nHsH tHD`D NormalCJOJQJ_HmH sH tH DA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List 4 @4 Footer  !<>@< Title$a$5CJOJQJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vj\{cp/IDg6wZ0s=Dĵw %;r,qlEآyDQ"Q,=c8B,!gxMD&铁M./SAe^QשF½|SˌDإbj|E7C<bʼNpr8fnߧFrI.{1fVԅ$21(t}kJV1/ ÚQL×07#]fVIhcMZ6/Hߏ bW`Gv Ts'BCt!LQ#JxݴyJ] C:= ċ(tRQ;^e1/-/A_Y)^6(p[_&N}njzb\->;nVb*.7p]M|MMM# ud9c47=iV7̪~㦓ødfÕ 5j z'^9J{rJЃ3Ax| FU9…i3Q/B)LʾRPx)04N O'> agYeHj*kblC=hPW!alfpX OAXl:XVZbr Zy4Sw3?WӊhPxzSq]y $   8@0(  B S  ? `ݰaݰbݰcݰdݰeݰfݰgݰhݰ ++;  $$7GG 9*urn:schemas-microsoft-com:office:smarttagsplace= *urn:schemas-microsoft-com:office:smarttags PlaceName=*urn:schemas-microsoft-com:office:smarttags PlaceType    sx7< 33+ \ DyRxUx\ 9 hX$^+9o4!v8G|<mF;)FG2K"aus{9_^2)9LA @ @@Unknown G.[x Times New Roman5Symbol3. .[x ArialY New YorkTimes New RomanO5 CourierCourier NewW,|8DengXian LightI{~ LightC.,.{$ Calibri Light? |8DengXianI{~7..{$ CalibriA$BCambria Math"''Zk  !;20 3;@P?2)2! xxYG study abroad releaseComputing ServicesSydney Robertson Oh+'0@ 4@ ` l x study abroad releaseComputing ServicesNormalSydney Robertson2Microsoft Office Word@@^D@M @M  G?VT$m {  !1."System-"Systemr[|ό -"System--@Times New Roman--- q2 <pD0 BRYN MAWR COLLEGE, HAVERFORD COLLEGE, AND SWARTHMORE COLLEGE RELEASE             2 <0   @Times New Roman--------- Y2 K40 FOR STUDENTS ENGAGING IN CIVIC ENGAGEMENT ACTIVITIES             ---  2 Kj0     2 Y00     2 h00     2 w00    82 00 Name of Person Giving Release:      2 0    2 0  0  2 0  0  2 P0  0  2 0  0  2 0  0  2 0  0  2 0  @Times New Roman---- @ ! - --- #2 00 (Student's name    2 0   2 0   2 0 please print)  2 0     2 00     2 00     2 00    2 0 0 Releasees:   2 i0  ' 2 m0 1) 91ֱ, Haverford College, and Swarthmore College, their agents and employees including Boards              b2 :0 of Trustees, Administration, Faculty, Staff, and Students.    2 0    .2 00    2 }0    2 00 Release:   2 ^0  2 ^2 70 I release and give up all claims, including claims for    2  0 negligence  2 0   A2 $0 I now have or may have in the future    2 0   2 0 against   y2 I0 Releasees arising out of my participation in the following activity:    D2 &0 ______________________________________  2 0     2 g0    2 (v0 I also understand that the activity set forth above is undertaken by me on a completely voluntary basis. I make this      2 7r0 decision by choice and my participation in this activity is undertaken knowing that risks may be involved. These      2 Fy0 risks include, but are not limited to, arrest, incarceration, and resulting criminal record, property loss or damage and      C2 T%0 physical or emotional injury, tempora   2 T[P0 ry or permanent, and death. I voluntarily assume the risks of these dangers by     2 co0 choosing to participate in the activity. I understand Releasees do not assume any risk or liability due to my      2 rz0 participation in this activity. I understand this Release applies to all claims for property loss, injury or illness, or     2 r0 death or any other damages suffered by me, now or in the future, whether suffered in traveling to the activity or       72 0 during the activity itself.   2 0     2 00    \2 60 I further state that I am at least eighteen (18) years   2 0   d2 ;0 of age and fully competent to sign this Release; and that I    2 0   2 0 execute   2  0 this Release   2 0   D2 &0 in consideration of the opportunity to 2 0   n2 B0 participate in the activity granted by Releasees, fully intending    )2 0 to be bound by it.   2 0     2 00    2 h0 I further agree that this Release shall be construed in accordance with the laws of the Commonwealth of         2 v0 Pennsylvania. If any term or provision of this Release shall be held illegal, unenforceable, or in conflict with any      2 O0 law governing this Release, the validity of the remaining portions shall not be     2 00   %2 30 affected thereby.  2 0     2 00    2 #00 Binding:   2 #^0  2 2 #q0 This Release binds me, my heirs and personal representatives. I understand that it benefits the heirs, personal      ^2 270 representatives or successors and assigns of Releasees.   2 20     2 A00    2 O00 Signing:  2 O[0  5 [2 O50 Before signing my name to this Release, I state that:      2 O0     2 ^00    2 m0 1)  2 m0  % "2 m0 I have read it,  2 m 0    2 |0 2)  2 |0  % h2 |>0 I understand it and know that I am giving up important rights,     2 |0    2 0 3)  2 0  % @2 #0 I intend to be legally bound by it.  2 s0     2 00     2 00     2 00    2 0R0    2 A0    2 P0  0 12 0    2 0    2 0  - @ !0-- @ !S- --- 2 0 0 Student's S @2 k#0 ignature (18 years of age or older)  2 !0  /  2 P0  0 2 0 Date   2 0     2 00    #2 00 Date of Birth:   ;2  0    2 0    2 0  - @ !j- ---  2 00     2 00    M2 0,0 Please return this completed waiver form to:     2 0    %2 -00 91ֱ      2 -0    2 <0 0 Career &   #2 <e0 Civic Engagement    2 <0   2 <0 Center   2 <0    2 J0 0 Student Life   2 Jv0 &   2 J0   %2 J0 Wellness Building    2 J0    2 Y0 0 (610) 526   2 Yh0   2 Yo0   2 Yr0 6591  2 Y0     2 h00   --- 2 w0n0 ** Any student seeking reimbursement for travel expenses to and/or from this event must submit this completed         2 w0 form   2 w0   2 w0 PRIOR    @1Courier New--------- ^2 070 to the event and any related request for reimbursement.    2 m0   2 r0 **---  2 0   "Arial--  00//.. YE ՜.+,0  hp  91ֱ  study abroad release Title  !"#$%&'(*+,-./0123456789:;<=>?@ABCDEFGHIKLMNOPQTRoot Entry FM VData 1Table=!WordDocumentDSummaryInformation()ADocumentSummaryInformation8JCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q