California State University, Fresno
Off-Campus Event, Form 2/ CSU Executive Order 1062
RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND
AGREEMENT TO PAY CLAIMS
Activity:
Activity Date(s) and Time(s):
Activity Location(s):
In consideration for being allowed to participate in this Activity, on behalf of myself and my next of
kin, heirs and representatives, I release from all liability and promise not to sue the State of
California, the Trustees of The California State University, California State University, Fresno, The
California State University Association, Inc., and all of said entities’ employees, officers, directors,
volunteers and agents (collectively “University”) from any and all claims, including claims of the
University’s negligence, resulting in any physical or psychological injury (including paralysis and
death), illness, damages, or economic or emotional loss I may suffer because of my participation in
this Activity, including travel to, from and during the Activity.
I am voluntarily participating in the Activity. I am aware of the risks associated with traveling
to/from and participating in this Activity, which include but are not limited to physical or
psychological injury, pain suffering, illness, disfigurement, temporary or permanent disability
(including paralysis), economic or emotional loss, and/or death. I understand that these injuries or
outcomes may arise from my own or other’s actions, inaction, or negligence; conditions related to
travel; or the condition of the Activity location(s). Nonetheless, I assume all related risks, both
known or unknown to me, of my participation in this Activity, including travel to, from and
during the Activity.
I agree to hold the University harmless from any and all claims, including attorney’s fees or damage
to my personal property, that may occur as a result of my participation in this Activity, including
travel to, from and during the Activity. If the University incurs any of these types of expenses, I
agree to reimburse the University. If I need medical treatment, I agree to be financially responsible
for any cost incurred as a result of such treatment. I am aware and understand that I should carry my
own health insurance.
I am 18 years or older. I understand the legal consequences of signing this document, including
(a) releasing the University from all liability, (b) promising not to sue the University, (c) and
assuming all risks of participating in this Activity, including travel to, from and during the
Activity.
I understand that this document is written to be as broad and inclusive as legally permitted by the
State of California. I agree that if any portion is held invalid or unenforceable, I will continue to be
bound by the remaining terms.
I have read this document, and I am signing it freely. No other representations concerning the legal
effect of this document have been made to me.
Participant Signature:
Participant Name (print): Date:
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