HEREAS, Union Health is an integrated health system consisting of Union
Health System, Inc., Union Hospital, Inc., Union Associated Physicians Clinic,
LLC, and their affiliates and subsidiaries (“Union Health);
WHEREAS, Union Health, in collaboration with Indiana State University
(“University), sponsors and conducts a Careers in Action program (“Activity”)
designed to provide students an opportunity to learn about health-related
careers;
WHEREAS, the individual signing this Agreement (“Participant”) desires to
participate in the Activity; and
WHEREAS, Union Health and University are willing to and is willing to
permit Participant to participate in the Activity, upon the terms and
conditions of this Agreement.
NOW THEREFORE, in consideration of being provided the
opportunity to participate in the Activity, the Participant hereby agrees as
follows:
1.
Release from Liability. I hereby release,
waive, discharge Union Health University, and their respective trustees,
directors, officers, employees, servants, agents, representatives, and
successors, including the assigned chaperones (collectively, the "Released
Parties") from any and all liability, claims, demands, damages, legal
actions and causes of action related to any and all loss, damage, or injury,
including death, that may be sustained by me or to any personal property,
whether caused by the negligence of the Released Parties or otherwise, while
participating in Activity or while in or
upon the premises where the Activity is being conducted. This release of
liability shall be binding upon me personally, as well as upon my heirs,
executors, and all members of my family.
2.
Covenant Not to Sue. I agree, for myself and all my heirs,
not to sue the Released Parties or initiate or assist in the prosecution of any
claim for damages or cause of action against the Released Parties which I or my
heirs may have as a result of any personal injury, death or property damage I
may sustain while participating in the Activity or while on or using the
premises where the Activity is being conducted.
3.
Indemnification. I hereby agree to defend, indemnify
and hold harmless the Released Parties from and against any third-party losses,
damages, actions, suits, claims, judgments, settlements, awards, interest,
penalties, expenses (including reasonable attorneys' fees) and costs of any
kind for any personal injury, loss of life or damage to property sustained by
reason of or arising out of my participation in any Activities or use of the
premises where the Activity is being conducted.
4.
Medical Release. I hereby authorize Union Health
and/or University to secure, and I consent to, any emergency medical treatment that
may become necessary as a result of my participation in the Activity or my
being on the premises where the Activity is conducted. I accept full
responsibility for all costs related to my medical treatment, including any
transport costs, and I release all parties involved from any type of liability
for anything that may happen during my treatment or transport.,
5.
Consent to Photograph or Video. I understand that
any photograph, video or audio recording, and/or any other image or likeness of
myself participating in the Activity becomes the property of Union Health and
Indiana State University and may be used by Union Health and/or Indiana State
University for the purpose of publicity of the Activity without any further
consent or request for consent.