RETURN TO CSUN HOMEPAGE
Insurance & Risk Management
ENVIRONMENTAL HEALTH & SAFETY
TEL NO: (818) 677-2079
FAX NO: (818) 677-5853
MAIL DROP: 8284
Volunteer Informed Consent
Release and Hold Harmless Agreement
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Participant's Name:

Activity:

In consideration of the acceptance of my voluntary participation in the above event, I hereby waive, release and discharge any and all claims for damages for death, personal injury or property damage which I may have, or which may hereafter accrue to me, against the California State University (University) as a result of my participation in the event.
This release is intended to discharge the State of California, California State University, Northridge, its Trustees, officers, employees and volunteers from and against any and all liability arising out of or connected in any way with my participation in the event, even though that liability may arise out of the negligence of the carelessness on the part of the University or persons mentioned above.
I further understand that accidents and injuries can arise out of this activity; knowing the risk, nevertheless, I hereby agree to assume those risks and to release and to hold harmless the University and persons mentioned above, who (through negligence or carelessness) might otherwise be liable to me (or my heirs or assigns) for damages.
It is further understood and agreed that this waiver, release and assumption of risks is to be binding on my heirs and assigns.
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Participant Signature: Date:
   
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Witness Signature: Date:
   
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