University of Southern Maine

Outdoor Adventure Board (OAB)

Release and Assumption of Risk

I, ______, of
Full Name – Legible Please Complete Address

being of legal age (having been born on ), acknowledge, declare and agree as

follows: Date of Birth

1. That I have voluntarily agreed to participate in the Outdoor Adventure Board (OAB) (hereinafter "Program"), offered during the Academic Semester and in consideration of being permitted to participate in this Program, do voluntarily execute this "Release and Assumption of Risk" on behalf of my self, my heirs and next-of-kin, my personal representatives and my estate.

2. I acknowledge that I am fully aware of the nature, scope and demands of the Program, and I understand that this Program may include other similar activities which could be dangerous to me. Such dangers, hazards and risks of this Program may include but are not limited to, injuries and illnesses inflicted by the following: transportation, strenuous physical activity, traveling on uneven terrain, exposure to weather, equipment failure, and plant and animal contact.

3. I accept and assume full responsibility for all harm and injury, of every nature, including death, which may occur to me or which I may suffer, and for all damages or loss to any personal property owned be me, while I am participating in this Program and, in furtherance thereof, I agree to indemnify and hold harmless the University of Maine System and the University of Southern Maine (hereinafter "University"), its Trustees, faculty, employees and agents from and against any and all claims, demands, actions or causes of action, on account of damage or loss to my personal property, or my personal injury, or death, which may occur or result directly or indirectly from my participation in this Program, and which are not the direct result of any negligent act of the University, its Trustees, faculty, employees or agents.

4. I understand that it is not the purpose of this Program or the responsibility of the University that safety rules and regulations are taught, but only that reasonable safety standards be adhered to and agreed to by all participants. I acknowledge that the University does not serve as a guardian of participants' safety and its faculty, employees and agents will not be responsible for administering any required first aid, treatment or medication to me.

5. I declare that I am able to physically withstand and cope with the indicated rigors of this Program, with or without an accommodation. If an accommodation is needed, I will contact Jenny L. Nelson, 780-4173. I understand that reasonable accommodations must be received 2 working days (Monday through Friday 9am to 4pm) before the event.

6. I request that this "Release and Assumption of Risk" be construed and interpreted pursuant to the laws of the State of Maine, and if any portion thereof is held invalid, I request the remainder continue in full force and effect.

7. I understand and agree that the University has the right to remove me from the Program if in its sole discretion the University determines that I am a danger to myself or any other person, and that the University in its sole discretion may cancel a Program at any time for safety reasons.

8. I understand that guests under 18 years of age are the sole responsibility of the parent/guardian/student to supervise and to inform/enforce the rules and directions of the activity. Parents/guardians/students are expected to use good judgment when signing children up for programs as to whether the child has the ability to participate in the program and to understand and follow the directions and rules.

9. I hereby give my consent to be photographed while participating in this program and to use such photographs for advertising purposes, including web pages, displays and brochures.

I declare that I completely understand and have fully informed myself of the terms and conditions of this "Release and Assumption of Risk" by having read it, or having it read to me, before signing.

Assented and agreed to on this day of ______,

Signature Date

Parent or Guardian (if under the age of 18 years)