INDEPENDENT RESEARCH – Minor Consent
WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT
In consideration of the University’s agreement to permit my son or daughter to participate in the aforementioned Program, the receipt and sufficiency of which consideration is hereby acknowledged, I agree as follows:
1) I, individually, and on behalf of my minor child and our respective heirs, successors, assigns and personal representatives, hereby release, acquit and forever discharge the University and its employees, students, agents, servants, officers, trustees and representatives (in their official and individual capacities) from any and all liability whatsoever for any and all damages, losses or injuries (including death) to persons or property or both, including but not limited to any claims, demands, actions, causes of action, damages, costs, expenses and attorneys fees, which arise out of, during or in connection with my child’s participation in the aforementioned Program, including but not limited to any damages, losses, or injuries to persons or property or both, which may be sustained or suffered by my child or any person in connection with my child’s association with, or participating in the Program, or arising out of his or her travel to or from the University.
2) I, individually, and on behalf of my minor child and our respective heirs, successors, assigns and personal representatives, hereby agree to indemnify, defend and hold harmless the University and its employees, students, agents, servants, officers, trustees and representatives (in their official and individual capacities) from any and all liability, loss or damage they or any of them incur or sustain as a result of any claims, demands, actions, causes of action, judgments, costs or expenses, including attorneys fees, which result from, arise out of or relate to my child’s participation in the Program, or arising out of his or her travel to or from the University.
3) I agree that this Waiver, Release and Indemnification Agreement is intended to be broad and inclusive as permitted by the laws of the State of Indiana, and if any portion hereof is held invalid, it is agreed that the balance hereof shall, notwithstanding, continue in full legal force and effect.
4) I hereby acknowledge and accept that there are certain risks including bodily injury and death, inherent in being in laboratories and participating in laboratory experiments, and that I have explained these risks to my child. I have knowingly and voluntarily decided to assume the risk of these inherent dangers in consideration of the University’s permission to allow my minor child to participate in the Program.
5) I represent and warrant that my child is covered throughout the Program by a policy of
6) I hereby consent to any publicity, including the use of my child’s name and likeness in
7) In signing this Waivers, Release, and Indemnification Agreement, I hereby acknowledge and represent that I have read this entire document, that I understand its terms and provisions, that I understand it affects my legal rights and those of my child, that it is a binding Agreement, and that I have signed it knowingly and voluntarily.
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Parent or Guardian’s Signature / Child’s Name (Print)
Date