Waiver Release

In consideration for the opportunity to participate in the off-campus educational activity organized by Utah Tech University (“University”) identified as the

, that is scheduled to occur during the
period from

through

(the "Activity"), I and, if I am not yet 18 years old, my parent or legal guardian (individually and collectively referred to below in the first person singular) agree
to be bound by each of the following:

1. Assumption of Risk. I expressly acknowledge that I am not required to participate in the Activity. Accordingly, I voluntarily accept personal responsibility for any liability, injury, loss, or damage
   in any way connected with my participation in the Activity.
2. Identification of Risks. I understand that there are certain dangers, hazards, and risks inherent in
   travel and the activities included in the Program or Activity. I understand that such dangers, hazards,
   and risks may involve risk of injury and loss, both to person and property. I further understand that the
   risk of injury may include the possibility of permanent disability and death. There may be other risks not known to the
   University or not reasonably foreseeable at this time. I understand that these risks of injury and loss
   might result from the actions, inactions, negligence, or conduct of the University or others, the rules of
   the Activity, or the condition of the premises, the facilities, or any equipment used in
   the Activity. I further understand that the University cannot and does not assume
   responsibility for any such injury or loss.
3. Waiver and Release. I waive and release the University, and their directors, officers, sponsors,
   employees, agents, volunteers, successors and assigns, if any, from all claims for any liability, injury, loss,
   or damage in any way connected with my participation in the Program and/or Activity, whether or not
   caused in whole or part by the negligence of any of the organizations or individuals mentioned above.
4. Indemnification. I agree to indemnify and hold harmless (in other words to reimburse and be responsible
   for) the University, and directors, officers, sponsors, employees, agents,
   volunteers, successors, and assigns from all claims for any liability, injury, loss, or damage in any way
   connected with or arising out of my participation in the Activity, whether or not caused
   in whole or in part by the negligence of any of the organizations or individuals mentioned above.
5. Consent to Medical Treatment. I agree that the University or may provide to me,
   through medical personnel of their choice, customary medical assistance, transportation, and
   emergency medical services. I understand and agree that the University assumes no responsibility for
   any injury or damage that might arise out of or in connection with such authorized medical treatment. I
   further agree that any expense resulting from the provision of such medical services is my responsibility.
   This consent does not impose a duty upon the University to provide such assistance,
   transportation, or services.
6. Binding Effect. This instrument shall be binding upon my relatives, personal representatives, heirs,
   beneficiaries, next of kin, or assigns and shall inure to the benefit of the University,
   and their respective successors and assigns.
7. Invalidity/Unenforceability. If any provision of this instrument is held to be invalid or unenforceable,
   this instrument shall be construed as if such valid or unenforceable provision was not contained herein,
8. Applicable Law. Because the University is a state institution located in St. George, Utah, this
   instrument shall be governed, construed and enforced in accordance with the laws of the State of Utah.

I HAVE READ THIS WAIVER, RELEASE OF LIABILITY, INDEMNIFICATION, AND CONSENT. I UNDERSTAND
THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. I AM SIGNING THIS WAIVER, RELEASE OF
LIABILITY, INDEMNIFICATION, AND CONSENT VOLUNTARILY,