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CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
a campus of the California State University ▪ Bakersfield ▪ Channel Islands ▪ Chico ▪ Dominguez Hills ▪ Fresno ▪ Fullerton ▪ Hayward ▪ Humboldt ▪ Long Beach ▪ Los Angeles
Maritime Academy ▪ Monterey Bay ▪ Northridge ▪ Pomona ▪ Sacramento ▪ San Bernardino ▪ San Diego ▪ San Francisco ▪ San Jose ▪ San Luis Obispo ▪ San Marcos ▪ Sonoma ▪ Stanislaus
RELEASE OF LIABILITY, WAIVER OF RIGHT TO SUE, ASSUMPTION OF RISK AND
AGREEMENT TO PAY CLAIMS
Activity: City of Ventura Corporate Games 2017 – Play for the Fun of It!
Activity Date(s) and Time(s): Jan. 18, 2017 through May 6, 2017
Activity Location/Facility: all meetings, practices, travel, games and events associated with 2017
Corporate Games. Employees must be 18 years of age and work a minimum of 20 hours per week. Participants must carry
approved proof of employment at all events.
In consideration for being allowed to participate in this Activity, I release from liability and waive my right to sue the
State of California, the Trustees of the California State University, which own and operate California State University,
Channel Islands and their employees, officers, volunteers and agents (collectively “University”) from any and all claims,
including the University’s negligence, resulting in any physical injury, illness (including death) or economic loss that I
may suffer because of my participation in this Activity, including any travel to and from the Activity.
I am voluntarily participating in this Activity. I understand that there are risks, such as physical and/or psychological
injury, pain, suffering, illness, disfigurement, temporary or permanent disability or even death, which may occur from my
participation in this Activity. These injuries or outcomes may arise from my own or other’s actions, inactions, negligence,
or from the condition of the Activity location(s) or facility(ies). Nonetheless, I assume all related risks, whether
known or unknown to me, of my participation in this Activity, including travel to and from the Activity.
I agree to hold the University harmless from any and all claims, loss or damage to my personal property, liabilities
and costs, including attorney’s fees, as a result of my participation in this Activity, including travel to and from the
Activity. If the University incurs any of these types of expenses, I agree to reimburse the University.
If I need medical treatment, the University is authorized to obtain medical treatment for me. I will be financially
responsible for any costs of such treatment. I agree that I will not hold the University responsible for any claims resulting
from any medical treatment. I am aware that the University does not provide health insurance for me and I should carry
my own health insurance.
I am 18 years or older. I have read this document, and I am signing it freely. I understand the legal consequences of
signing this document, including (a) releasing the University from all liability, (b) waiver of my right to sue the
University, (c) and assumption of all risks of participating in this Activity, including travel to and from 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.
Participant Name (Print): _________________________________ Date: ______________________
Signature: _____________________________________________
One University Drive, Camarillo CA 93012 (805) 437-8400 Fax (805) 437-8424
