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LIFT Tour Participant Liability/Photo Acknowledgement Form

Student Leadership University (SLU) is honored to have you participate in one of our incredible experiences. As you join us, we need to let you know a few things, and we ask that you fill out this form before you or your student joins us. This form must be submitted in order to participate in the LIFT Tour.

LIABILITY WAIVER INFORMATION

The undersigned desires to participate in various programs, events and activities (hereinafter collectively referred to as "Activities") operated by Student Leadership University. The undersigned further understands and acknowledges that you understand that there is always a possibility of injury or physical harm while participating in such activities.

  • Before you or your student can join SLU in one of these amazing experiences, you agree that Student Leadership University cannot let anyone participate in any activities without releasing and holding harmless Student Leadership University.
  • The undersigned acknowledge an inherent risk of exposure to illness exists in any public place where people are present. You also acknowledge your voluntary compliance with all event precautions SLU may take if regional or global recommendations necessitate this.  You further acknowledge your responsibility in making a wise decision on whether to attend this event – and that you should not attend if you are exhibiting systems of a contagious illness.
  • Further, the undersigned agrees to hereby release, and forever discharge Student Leadership University, their officers and directors, and their employees, their agents, and any parties volunteering on behalf of Student Leadership University for all actions, claims, damages, costs, expenses or damages of any kind growing out of or related to any activity of Student Leadership University in which the undersigned participates.
  • You further acknowledge that this is a full and complete release for all injuries and damages which may be sustained as a result of participating in any Student Leadership University program. 

I Agree

PHOTO RELEASE

By registering you or your student for an SLU experience, you give Student Leadership University permission to use photography, video, and audio that you or your student is in for any publication related to telling others about their experience with an SLU program. You give permission to Student Leadership University to use such images (including self-submitted) in connection with any publication including but not limited to brochures, booklets, reports, websites, including social media, and exhibits, to use and cite any comment(s), verbal or written, made by you or your child about the program, and to use you or your child’s name in connections with any publication and in such manner as determined by SLU without compensation. If you would prefer we not take photographs or video, please notify us via e-mail.

I Agree

ACKNOWLEDGEMENT

I acknowledge I have read the above authorization, release, and agreement, prior to its execution, and that I am fully familiar with the contents of it.  This release shall be binding upon the minor and me and our respective legal representatives. SLU and its partners will protect your information but may use it for promotional purposes.

I Agree

Please select who will be attending
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First Attendee's Name

First Name*

Last Name*

Phone*
First Attendee's Date of Birth*
First Attendee's Information
Group You Are Attending LIFT Tour With (if applicable):*
Which of the following best describes the attendee?*
Student High School Graduation Year (ONLY Students)*
First Attendee's Signature*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Group You Are Attending LIFT Tour With (if applicable):*
Which of the following best describes the attendee?*
Student High School Graduation Year (ONLY Students)*
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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