PERSONS ON NON-EMPLOYEE WORKING STATUS
BY SIGNING THIS D
OCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS,
INCLUDING THE RIGHT TO SUE – PLEASE READ CAREFULLY!
Name:
Student #:
Email:
Phone #:
RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY:
In consideration of approval to enter a work experience program in the University of Guelph’s
, I hereby agree as follows:
TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the University of Guelph and its
directors, officers, employees, and representatives (all of whom are hereinafter collectively referred to as “The
Releasees”);
TO RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I may
suffer, or that my next of kin may suffer as a result of my participation in this work experience program, due to
any cause whatsoever, including negligence, breach of contract or breach of any statutory or other duty of care.
IT IS MY RESPONSIBILITY to ensure I have adequate medical, personal health, dental and accident insurance
coverage, as well as protection of my person possessions;
TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage to
property of, or personal injury to, any third party, resulting from my participation in this work experience program,
if such liability is as a result of my acting outside the scope of my duties and responsibilities.
THIS AGREEMENT SHALL be effective and binding upon my heirs, next of kin, executors, administrators,
assigns and representatives in the event of my death or incapacity;
IN ENTERING INTO THIS AGREEMENT, I am not relying upon any oral or written representations or
statements made by the Releasees other than what is set forth in this Agreement.
I FREELY ACCEPT AND FULLY ASSUME all risks, dangers and hazards and the possibility of personal injury,
death, property damage or loss, resulting from my participation in this program.
I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS
AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS,
ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.
PLEASE NOTE: Before volunteer status can be granted the following EHS Safety Certificates must be completed.
Students self-register for the courses here: https://ehs.opened.uoguelph.ca/index.cfm
EHS Worker Health and Safety Awareness
Please email copies of all completed safety certificates (MERGED INTO A SINGLE PDF) to davisonc@uoguelph.ca
I certify that the above volunteer has 1) completed all required safety quizzes, 2) has provided me with a copy of all
4 c
______________________
ertificates to be placed in the lab safety binder and 3) has emailed the PDF copy to davisonc@uoguelph.ca.
Name of Supervisor: ___________________ Supervisor Signature:
Name of Chair/Director: ___________________ Signature of Chair/Director: ______________________
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