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Community Service Learning Working With Animals Waiver

Willamette University

Sponsoring Organization: Community Service-Learning

Waiver of Liability, Indemnity Agreement, & Assumption of Risk

 

Waiver of Liability and Indemnification Agreement

Waiver: In consideration of permission to participate, today and on all future dates, the property, facilities and services of Willamette University (WU), I, on behalf of myself, my heirs, personal representatives, or assigns, do hereby release, waive, discharge, and covenant not to sue WU, its directors, officers, employees, student volunteers, independent contractors, administration, or trustees from liability from any and all claims arising from the ordinary negligence of WU or any of the aforementioned parties. This agreement applies to personal injury including paralysis or death, from accidents or illness arising from participating in WU activities including, but not limited to, community service, organized activities, classes, observation, and individual use of facilities, premises, or equipment; and to any and all claims resulting from the damage to, loss of, or theft of property.

Indemnification and Hold Harmless: I also agree to HOLD HARMLESS AND INDEMNIFY WU from all claims resulting from ordinary negligence and to reimburse them for any expenses incurred as a result of my involvement with WU. I further agree to pay all costs and attorneys’ fees incurred by WU in investigating and defending a claim or suit if my claim is withdrawn, or to the extent a court or arbitration determines that WU is not responsible for the injury or loss.

Severability & Venue: The undersigned further expressly agrees that the foregoing waiver and assumption of risk agreement is intended to be as broad and inclusive as is permitted by the law of the State of Oregon and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Likewise, I agree that if legal action is brought, it must be brought in Marion County, Oregon.

Acknowledgment of Understanding: I have read this waiver of liability and indemnification agreement and fully understand its terms. I understand that I am giving up substantial rights, including my right to compensation for injury. I acknowledge that I am signing the agreement voluntarily, and intend my signature to be a complete and unconditional release of all liability for ordinary negligence to the greatest extent allowed by law in the State of Oregon.

Waiver Agreement, I have read this waiver of liability and indemnification agreement and fully understand its terms.

I Agree
 

 

Assumption of Risks

Physical and/or outdoor activity, by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. WU promotes service opportunities which can include interactions with people in need, donation sorting, tree planting, cleanup of natural and urban areas, mentoring or tutoring youth, work with animals, yard work, and other types of activity. Some of these involve exertions of strength (such as moderate lifting) using various muscle groups and may involve sustained physical activity which places stress on the muscular and cardiovascular systems.

The specific risks vary from one activity to another, but in each activity the risks range from minor injuries such as scratches, scrapes, insect bites and stings, bruises and sprains to major injuries such as loss of sight, joint or back injuries, skeletal breaks, tissue lacerations, puncture wounds, burns,

concussions, and heart attacks to catastrophic injuries including paralysis and death.

Nature of the Activities: I fully understand that as a part of my volunteer work, I will become in contact with animals either by direct handling or assisting in their care. Further, I understand that working with animals carries a risk of injury, and that it is possible that I may be bitten, scratched, and/or otherwise injured. I also understand that I may be exposed to illness and disease and that it is also possible that I could indirectly expose my own pets to such illness and disease. I also understand that the behavior of animals is at times unpredictable and that some animals are capable of inflicting property damage, serious personal injury, and even death. I realize that by volunteering with animals, I am exposing myself to such dangers. I am well aware of the risks of handling animals.

I have read the previous paragraphs and I know the nature of the activities within this WU service event in which I am participating, and I understand the demands of those activities relative to my physical condition and skill level, and I appreciate the types of injuries which may occur as a result of activities made possible by WU. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.

Acknowledgment of Understanding: I have read this assumption of risk and fully understand its terms. I acknowledge that I am signing the agreement freely and voluntarily and intend my signature to signify a complete assumption of the inherent risks of participating in or observing community service activities from WU to the greatest extent allowed by law in the State of Oregon.

Assumption of Risks, I have read this assumption of risks agreement and fully understand its terms.

I Agree
 

I have had sufficient opportunity to read this entire document. I have read and understood it, and I/we agree to be bound by its terms.

By applying my electronic signature to this agreement, I agree that my electronic signature is the legally binding equivalent of my handwritten signature on paper. I will not, at any future time, claim that my electronic signature is not legally binding or enforceable. By electronically signing and submitting this agreement, I: 1) acknowledge that I have read and fully understand the terms of the agreement; 2) voluntarily agree to be bound by this agreement; and 3) certify that I am 18 years of age or older.

Today's Date: March 22, 2023 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

WU ID Number: *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

WU ID Number: *
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

WU ID Number: *
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

WU ID Number: *
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

WU ID Number: *
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

WU ID Number: *
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

WU ID Number: *
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

WU ID Number: *
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

WU ID Number: *
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

WU ID Number: *
Parent or Guardian's Email Address

Email*

Confirm Email*
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Activity Information

Name of Activity (Include name of Community Partner): *

Date of Activity: *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

WU ID Number: *
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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