Releaseofliability,Promisenottosue,Assumptionofriskandagreementtopayclaims

RELEASEOFLIABILITY,PROMISENOTTOSUE,ASSUMPTIONOFRISKANDAGREEMENTTOPAYCLAIMS

Activity:ParticipationintheWRPIWater ResourcesExperientialLearningforUSDACareersInternshipProgram

ActivityDate(s)andTime(s): ActivityLocation(s):

In considerationforbeingallowedtoparticipate inthisActivity, onbehalfof myselfandmynextof kin,heirsandrepresentatives,IreleasefromallliabilityandpromisenottosuetheStateofCalifornia,theTrusteesofThe CaliforniaStateUniversity, CaliforniaState UniversitySanBernardino,SonomaStateUniversity,WaterResourcesandPolicyInitiatives,UniversityEnterprisesCorporationatCSUSB,andtheiremployees,officers,directors,volunteersandagents(collectively“University”)fromanyandallclaims,includingclaimsoftheUniversity’snegligence,resultinginanyphysicalorpsychological injury(includingparalysisanddeath),illness,damages,or economicoremotionallossImaysufferbecauseofmy participation inthisActivity,includingtravelto,fromand duringtheActivity.

IamvoluntarilyparticipatinginthisActivity.I amawareoftherisksassociatedwithtravelingto/fromandparticipatinginthisActivity, whichincludebutarenotlimitedtophysical orpsychologicalinjury,pain,suffering,illness,disfigurement,temporaryorpermanentdisability(includingparalysis), economicoremotional loss,and/ordeath.Iunderstandthatthese injuriesoroutcomesmayarisefrommyownorother’sactions,inaction,ornegligence;conditionsrelatedtotravel;ortheconditionoftheActivitylocation(s).Nonetheless,Iassumeallrelatedrisks,bothknownorunknowntome,ofmyparticipationinthisActivity,includingtravelto,fromandduringtheActivity.

IagreetoholdtheUniversityharmlessfromanyand allclaims,includingattorney’sfeesordamagetomypersonalpropertythat mayoccurasaresult of myparticipationinthisActivity,includingtravelto,fromandduringtheActivity.IftheUniversityincursanyofthese typesofexpenses,IagreetoreimbursetheUniversity.IfIneedmedicaltreatment,Iagreetobefinanciallyresponsiblefor anycostsincurredasaresultofsuchtreatment.Iamawareandunderstandthat Ishouldcarrymyownhealth insurance.

Iam18yearsorolder.Iunderstandthelegalconsequencesofsigningthisdocument,including(a)releasingtheUniversityfromallliability,(b)promisingnottosuetheUniversity,

(c)andassumingallrisksofparticipatinginthisActivity,includingtravelto,fromandduringtheActivity.

Iunderstandthatthisdocumentiswritten tobe as broadandinclusiveaslegallypermittedbytheStateofCalifornia.Iagreethatifanyportionisheldinvalidorunenforceable, I will continuetobeboundbytheremainingterms.

Ihave readthisdocument, andIamsigningitfreely.Nootherrepresentationsconcerningthelegaleffectof thisdocumenthavebeenmadetome.

ParticipantSignature:

ParticipantName(print):Date:

IfParticipantisunder18yearsof age:

Iam theparentorlegal guardian oftheParticipant.Iunderstandthelegal consequences ofsigningthisdocument,including(a)releasingtheUniversityfromallliabilityonmyandtheParticipant'sbehalf,(b)promisingnottosueonmyandtheParticipant'sbehalf,(c)andassumingallrisksoftheParticipant'sparticipationinthisActivity,includingtravelto,from,andduringtheActivity.IallowParticipanttoparticipate inthisActivity.Iunderstandthat Iamresponsiblefortheobligationsand actsofParticipantsasdescribedinthisdocument.Iagreetobeboundbythetermsofthisdocument.

Ihave readthistwo-page document, andIam signing itfreely.Nootherrepresentationsconcerningthelegal effect ofthisdocumenthavebeen madetome.

SignatureofMinorParticipant'sParent/Guardian

NameofMinorParticipant’sParent/GuardianDate

MinorParticipant'sName(print)