2020 ETSI LIABILITY WAIVER - FACULTY & STAFF
RELEASE, ASSUMPTION OF RISK AND COVENANT NOT TO SUE
TRAVEL TO INDIA
I have agreed to participate in the 2020 Emory-Tibet Science Initiative Summer/Winter Teacher Training Programs (“Program”) in South India through Emory University’s Center for Center for Contemplative Science and Compassion-Based Ethics. I acknowledge that my participation in this Program is entirely voluntary.
I understand that there are inherent risks involved with my travels to India and I acknowledge and accept all of these risks, including death. These risks include, but are not limited to, travel to, within and returning from my assigned teaching site in south India, inadequate infrastructure and public sanitation, weather conditions, wild and domestic animals, local medical conditions, modest living conditions including unreliable power and internet access, and danger of crime. With my signature below, I also agree that I will monitor any changes to this travel advice through the Emory University's Center for Contemplative Science and Compassion - Based Ethics website.
I understand that I will be traveling to an area of the world with endemic diseases. I acknowledge that Emory University has advised me to follow the applicable CDC guidelines for immunizations and malaria prophylaxis before and when traveling to India. Additionally I agree to take responsibility for my own health condition, to carry with me all routine medication for any chronic condition, and to consult my personal physician regarding additional medical precautions that may be recommended for my individual circumstances. I agree that I will provide the coordinator of the Program with my proposed itinerary and a contact phone number to be utilized in the case of an emergency.
I understand that Emory University does not warrant (or guarantee) in any respect the competency or mental or physical condition of any person associated with my travels abroad or the physical condition of any facility, vehicle or equipment used in connection with my travel abroad. I understand that Emory University does not provide me with any travel insurance or liability insurance in connection with my trip to India and my activities there. Any independent travel undertaken before or after the program is at my own expense and risk.
IN CONSIDERATION OF MY PARTICIPATION IN THE PROGRAM, I ACKNOWLEDGE AND VOLUNTARILY ASSUME ALL RISKS OF DAMAGES OR INJURY, INCLUDING DEATH, THAT I MAY SUSTAIN OR THAT MY PROPERTY MAY SUSTAIN WHILE I PARTICIPATE IN THE PROGRAM, ALONG WITH ANY TRAVEL TO OR FROM THE PROGRAM OR THE PROVISION OF TRANSPORTATION TO OR FROM THE PROGRAM.
Further, I hereby release, relieve, and covenant not to sue and forever discharge, defend, indemnify and hold harmless Emory University and its trustees, officers, agents, employees, students and volunteers of any and for all claims, demands, rights, liabilities, losses, expenses and causes of action of whatever kind or nature, including but not limited to negligence, unforeseen bodily and personal injuries, damage to property, and the consequences thereof, including death, resulting from the Program or any travel incident thereto.
I expressly agree that the terms of this Release, Assumption of Risk and Covenant Not to Sue (“Release”) shall be binding upon me and my heirs, executors and assigns, and all members of my family. I expressly agree that this Release shall be governed and interpreted in accordance with the laws of the State of Georgia without regard to conflict of law principles. I INTEND THIS TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT, IN THE EVENT THAT ANY CLAUSE OR PROVISION OF THIS RELEASE IS HELD TO BE INVALID BY ANY COURT OF COMPETENT JURISDICTION, THE INVALIDITY OF SUCH CLAUSE OR PROVISION SHALL NOT OTHERWISE AFFECT THE REMAINING PROVISIONS OF THE RELEASE.
IN SIGNING THIS RELEASE, ASSUMPTION OF RISK AND COVENANT NOT TO SUE, I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS ENTIRE DOCUMENT AND ITS ATTACHMENT, THAT I UNDERSTAND AND AGREE TO COMPLY WITH ITS TERMS, AND THAT I HAVE SIGNED IT KNOWINGLY AND VOLUNTARILY.
Faculty or Staff Team (check only one):
Electronic Signature: By typing your full name, including middle name or initial (if applicable), you are legally signing this Release, Assumption of Risk and Covenant Not to Sue
Date of Signature
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service