Greenbelt Day Trip
Friday January 20....
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Cost is FREE, y'all!

Transportation and snacks will be provided.
Personal Info
Name *
Age *
Email *
Phone Number *
SEU ID# *
Medical Info
Any Allergies? *
Dietary Restrictions? *
Please list any current medications *
Any other pertinent medical information? *
Emergency Contact Information
Emergency Contact Name *
Emergency Contact Number *
Emergency Contact Email *
Emergency Contact Relation *
Secondary Emergency Contact Name *
Secondary Emergency Contact Number *
Secondary Emergency Contact Relation *
SEU Emergency Authorization Release Form
Please Read Carefully! SIGN YOUR NAME BELOW!
St. Edward’s University, Inc. (“University”) is sponsoring the following activity, event or trip: Pedernales Falls State Park Camping Trip. As a condition of allowing participation in the Activity, the University requires all participants (or their guardians if the participant is under age 18) to sign this Participant Waiver and Hold Harmless Agreement. By signing this Agreement, the undersigned agrees to the following: 1. I am fully aware of the inherent risks involved with the Activity and travel relating to the Activity, including but not limited to ____all injuries related to outdoor activities up to and including death____. I choose to voluntarily participate in the Activity with full knowledge that the Activity may be hazardous to me and my property. 2. I understand the Activity may involve physically strenuous activities. I know of no medical reason why I should not participate. 3. I hereby accept and assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained as a result of participating in the Activity, INCLUDING INJURIES SUSTAINED AS A RESULT OF THE NEGLIGENCE OF THE UNIVERSITY OR ITS REPRESENTATIVES. 4. I hereby release and agree to indemnify and hold harmless the University and its affiliates, trustees, officers, employees, agents and contractors from and against any and all manner of actions, causes of action, suits and claims for damages of any kind, including claims for damages of any kind (including attorneys’ fees and costs) arising out of personal injury, death, property damage or other damage or loss (collectively "Losses"), that result from or arise in connection with my participation in the Activity, or that occur while I am on the premises owned or leased by the University. THIS RELEASE, INDEMNITY AND HOLD HARMLESS AGREEMENT ALSO INCLUDES, BUT IS NOT LIMITED TO, ALL CLAIMS BASED IN WHOLE OR IN PART ON THE NEGLIGENCE (EXCEPT GROSS NEGLIGENCE) OF THE PARTIES RELEASED ABOVE OR INJURIES RESULTING FROM THE EXERCISE OF JUDGMENT MADE IN GOOD FAITH. 5. I understand that the University does not maintain an insurance policy for my benefit covering circumstances arising from my participation in the Activity or related to such participation. As such, I am aware that I should review my personal insurance coverage if I wish to have insurance coverage for the Activity. 6. It is my express intent that this Waiver and Hold Harmless Agreement shall bind the members of my family, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be governed by the laws of the State of Texas. 7. I acknowledge and represent that I have carefully read this agreement and understand the agreement, the matters being released and my obligations hereunder. I execute this document voluntarily, for full, adequate and complete consideration fully intending to be bound by the same, now and in the future.
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