PARTICIPANT WAIVER AND HOLD HARMLESS FORM
FLORIDA ATLANTIC UNIVERSITY
1.In consideration for receiving permission to park private vehicles overnight on the___________
Campus, Lot ______________ of the Florida Atlantic University campus (“FAU Campus”) on
__________________________, 20__ (referred to as OVERNIGHT PARKING), I hereby RELEASE, WAIVE,
DISCHARGE, AND COVENANT NOT TO SUE, AND AGREE TO HOLD HARMLESS for any and all
purposes the Florida Atlantic University Board of Trustees, Florida Atlantic University, and the State of Florida,
and their respective officers, servants, agents, volunteers, or employees (herein referred to as RELEASEES)
FROM ANY AND ALL LIABILITIES, CLAIMS, DEMANDS, OR DAMAGES that may be sustained to my
person, my vehicle or my vehicle’s contents while parked on the FAU Campus, or while on the premises
owned or leased by RELEASEES, including injuries sustained as a result of the negligence of
RELEASEES.
2. I am fully aware that there are inherent risks involved with OVERNIGHT PARKING andI choose to
voluntarily participate in said activity with full knowledge that said activity may be hazardous to my person or
property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY
DAMAGE OR PERSONAL INJURY that may be sustained by my person, my vehicle, any of my vehicle’s
contents as a result of participating in said activity including injuries sustained as a result of the
negligence of RELEASEES. I further agree to indemnify and hold harmless the RELEASEES for any loss,
liability, damage or costs, including court costs and attorney’s fees that may occur as a result of my
participation in said activity.
3. I understand that RELEASEES may not maintain any insurance policy, or insurance in only limited
amounts, covering any circumstance arising from my participation in this activity or any event related to that
participation. As such, I am aware that I should review my personal insurance coverage.
4. It is my express intent that this Covenant Not to Sue and Agreement to Hold Harmless shall bind
the members of my family and spouse, if I am alive, and my heirs, assigns and personal representatives, if I
am deceased, and shall be governed by the laws of the State of Florida.
5. In signing this Covenant Not to Sue and Agreement to Hold Harmless, I acknowledgeIand
represent that I have read the foregoing Covenant Not to Sue and Agreement to Hold Harmless, understand
it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements
apart from the foregoing agreement that has been reduced to writing have been made. I execute this
document for full, adequate and complete consideration fully intending to be bound by the same, now and in
the future.
6. I understand that I am accepting the premises provided by the Releases’ as is.” I have
either inspected or been given the opportunity to inspect the premises provided by the Releases
and knowingly and voluntarily choose to proceed with the OVERNIGHT PARKING.
SIGNED this ____ dayof ____________, 20__.
Participant Signature: __________________________________________
Printed Name: _________________________________________________
Parent or Legal Guardian Signature: ______________________________
(If Participant is under 18 years old)
Parent or Legal Guardian Printed Name: ______________________________
(If Participant is under 18 years old)
Witness Signature: __________________________________________
Witness Printed Name:__
______________________________________
Make:
Model:
Color:
Year:
Tag #:
Z#:
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