WAIVER OF RESPONSIBILITY

(This form is adapted from material provided by the Temple University Office of Legal Counsel)

I agree to release Temple University of the Commonwealth System of Higher Education (and all its officers, employees and agents) from responsibility in all manner of actions and causes of action – i.e. suits, debts, accounts, judgments – including all claims arising out of incidents involving personal injury of any kind by reason of participation in the site visit to two sites downtown (10^th and Cuthbert Streets, and Broad and Locust Streets).

I assume any and all risks arising from my participation in this site visit, including, without limitation, the risks of bodily injury or property damage, the unavailability of emergency medical care, or the negligent acts of another person.

I will indemnify and hold harmless Temple University of the Commonwealth System of Higher Education (and its officers, employees and agents)  for any and all claims, causes of action, damages, judgments, costs or expenses that arise out of or relate to my own negligent or intentional acts or omissions.

The undersigned expressly acknowledges that he or she has read and understands this Agreement and Release and signs it freely and voluntarily. 

This waiver is intended to be legally binding.

Name (print) ________________________________________

Student ID#   ________________________________________

Signature   ____________________________________________

Date _____________________________________