PHIMAN SUMMIT 2018 - Registration Form
Please fill out registration form completely and check all answers before submitting. If you have any questions, please email: summit@psisigmaphi.org
Email address *
Deauville Beach Resort - Miami Beach, Florida June 7th - 10th
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Last Name *
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PHIMAN Email *
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Chapter *
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T-Shirt size *
Semester Pledged *
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Meal Preference *
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Waiver and Release of Liability
In consideration of the risk of injury while participation in the Phimen Summit (the “Activity”), and as consideration for the right to participate in the Activity. I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waivers and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Psi Sigma Phi Multicultural Fraternity. Inc. located in 5101 Collins Ave, Miami Beach, FL 33140, United States their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economic or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to the Activity.

Alcohol/Drug Policy:
Psi Sigma Phi Multicultural Fraternity, Inc. has a zero tolerance rule for possession or drinking of alcohol for any participants under the age of 21 and/or possession or use of any illegal drug or drug paraphernalia by any participant. Any participant violating this rule is subject to immediate expulsion from the Activity. In any such case, the member is responsible for his transportation, and waives any claim for any refund of any portion of the Activity cost.

I am voluntarily participating in the aforementioned “Activity” and I am participating in the “Activity” entirely at own risk. I am aware of the risks associated with traveling to and from as well as participating in the “Activity”, which may include, but are not limited to, physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others’ negligence, conditions related to travel, alcoholic consumption, or the condition of the Activity location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this Activity, including travel to, from and during this Activity.

Photo Release:
Psi Sigma Phi Multicultural Fraternity. Inc. reserves the right to take photographic or film records of any program. Psi Sigma Phi Multicultural Fraternity, Inc. may use such records for promotional and/or commercial purposes without limitation, without liability and without payment of any fees.

Binding Arbitration:
Any controversy or claim arising out of or relating in any way to these Terms and Conditions, to this Agreement, to the brochure, or any other information relating in any way to the “Activity”, or to the Activity itself, shall be resolved solely and exclusively by binding arbitration in Miami, Florida in accordance with the commercial rules of the American Arbitration Association then existent. In any such arbitration, the substantive (but not procedural) law of Florida shall apply. The arbitrator and not any federal, state, or local court or agency shall have exclusive authority to resolve any dispute relating to the interpretation, applicability, enforceability, conscionability, or formation of this contract, including but not limited to any claim that all or any part of this contract is void or voidable.

I agree to indemnify and hold harmless Psi Sigma Phi Multicultural Fraternity, Inc. against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Psi Sigma Phi Multicultural Fraternity, Inc. incurs any of these types of expenses, I agree to reimburse Psi Sigma Phi Multicultural Fraternity, Inc.

I acknowledge that Psi Sigma Phi Multicultural Fraternity, Inc. and their directors, officers, volunteers, representatives, and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Psi Sigma Phi Multicultural Fraternity, Inc.

I acknowledge that this Activity may involve social interactions which incurred drinking alcoholic beverages which by law are to be consumed by person(s) over the legal drinking age of 21 years of age. Participation of such activity includes risks associated but are not limited to, those caused by terrain, consumption, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others, including but not limited to participants, volunteers, spectators, event monitors, and/or participants of the event.

I acknowledge through the purchase of this ticket to the aforementioned “Activity” that I have carefully read this “waiver and release” and fully understand that it is release of liability. I expressly agree to release and discharge Psi Sigma Phi Multicultural Fraternity, Inc. and all of its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against Psi Sigma Phi Multicultural Fraternity, Inc. for personal injury or property damage.

To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of Psi Sigma Phi Multicultural Fraternity, Inc. its agents, and serving board/cabinet members.

In the event that any damage to equipment of facilities occurs as a result of my actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect and recklessness.

This Agreement was entered into at arm’s length, without duress or coercion, and is to be interpreted as agreement between two parties of equal bargaining strength. Both the Participant (signee), and Psi Sigma Phi Multicultural Fraternity, Inc. agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purpose for which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this Agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

A copy of your responses will be emailed to the address you provided.
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