Attachment III

 

Texas State University-San Marcos

Student Trip Release and Indemnity Agreement

 

Studentsí Name:_____________________________________________________________

Sponsoring Student Organization or Department:___________________________________

Academic Year:_____________________________________________________________

I plan to engage in university-sanctioned travel activities during the academic year indicated above in association with the above listed organization. I am traveling entirely upon my own initiative, risk, and responsibility.

 

In consideration for the permission given to me by Texas State University-San Marcos to take this trip and in further consideration for Texas State University-San Marcos and the organization named above facilitating this trip, I (for myself, my heirs, executors, and administrators) release, discharge, and agree to indemnify Texas State University-San Marcos, the organizationís advisors and all of the universityís agents and employees who have facilitated this trip, acting officially or otherwise, from any claims on account of any injury to me or for damages to my property that occur from any cause in connection with this trip. I intend that the indemnity provided for in this agreement is indemnity by me above to indemnify Texas State University-San Marcos and its agents and employees from the consequences of their negligence, whether that negligence is the sole or concurring cause of the death, injury or damage.

 

Dated this the ____________day of _______________, 20__________.

 

__________________________________________________________

Student Signature

 

__________________________________________________________

Parent or Guardianís Signature, if student is under 18