Medical Permission Form and
Release and Waiver of Liability
- Waiver and Release. The undersigned Student and/or Guardian do hereby release and forever discharge and hold harmless Union University, Jackson, Tennessee, the event chaperone and all other employees, agents or students participating in the activities and practices of the Campus & Community: A Day of Remembrance & Service, from any and all liability, claims and demands of whatever kind or nature, which may arise as a result of Student participation in the Campus & Community: A Day of Remembrance & Service.
Student and/or Guardian agree that this Release discharges Union University and all persons acting as agents of the University from any liability or claim that the Student and/or Guardian may have against the University with respect to any bodily injury, illness, death, property damage or any other damages of any nature, whatever the cause of such claims. Union University does not assume any obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance or benefits in the event of injury or illness.
- Medical Treatment. Student and/or Guardian hereby give consent for any employees, agents or student volunteers of Union University to arrange for emergency medical, surgical or dental care and treatment necessary to preserve the health of Student. Student and/or Guardian agree to be responsible for all charges incurred in connection with any care and treatment obtained for Student. Student and/or Guardian do hereby release and forever discharge Union University and its agents, employees and volunteers from any claim whatsoever that may arise on account of any first aid or medical treatment rendered to Student by any employee, agent, or fellow student of Union University, or on account of the decision by any employee, agent or student of Union University in the exercise of any power granted to them to consent to medical or dental treatment.
- Assumption of the Risk. Student and/or Guardian hereby expressly and specifically assume the risk of injury, damage or harm related to any activities or trips the Student may participate in with the Campus & Community: A Day of Remembrance & Service.
- Insurance. The Student and Guardian understand that Union University does not carry or maintain health, medical or disability insurance coverage for the Student. Each Student is expected and encouraged to obtain his or her own medical or health insurance coverage.
- Photographs. I do hereby authorize Union University and its assigns to utilize any and all photographs, pictures or other likeness of me or anyone assigned guardianship to me, as they deem
appropriate in its promotional materials or team films.
- Continuing Release. This Release and Permission Form shall continue to be in effect for one year after the date of this release, unless Student or
Guardian has hand delivered a written revocation of this release to Dr. Bryan Carrier, Acting Dean of Students at least 7 days prior to the effective date of the event.
Signature and ID sent electronically for agreement to the above release form will be considered to have the same effect as an original hard copy document.