RELEASE AND WAIVER OF LIABILITY FOR MINORS EDUCATIONAL TALENT SEARCH VEHICLE RELEASE FORM The undersigned hereby releases Northern Kentucky University, its officers, agents, employees, successors and assigns from any and all liability arising out of, or in any way related to, the use of a University vehicle, meaning any vehicle owned or leased by Northern Kentucky University, for transportation by Educational Talent Search to Cincinnati, OH for the purpose of our 9-12th grade college visit to Xavier University and the University of Cincinnati on Thursday, October 9, 2014. I hereby agree to save and hold harmless Northern Kentucky University, its officers, agents, employees, successors and assigns for any and all claims and causes of action arising out of, or in any way related to, the use of such charter vehicle. I understand that the vehicles used for transportation may not be equipped or reinforced to the specifications of a school bus. This agreement shall be binding upon my heirs, devisees and assigns. ________________________________ Signature of student participant _______________ Date ________________________________ Phone number I, _________________________________ (name of Parent/Legal Guardian), as Legal Guardian for the Minor signing above, do hereby ratify and adopt the full release of Northern Kentucky University from all liability of any kind as specified in the release above. ________________________________ Signature of Parent/Legal Guardian _______________ Date  I will meet the bus at 7:00am at the Grant County Center in Williamstown, KY.  I will meet the bus at 8:00am in front of NKU’s Student Union in Highland Heights, KY.  I will meet the bus at 8:30am at St. Bernard-Elmwood Place High School in St. Bernard, OH. Release executed on _______________ (today’s date and year), by ______________________________ (name of Parent/Legal Guardian), of ______________________________ (name of student participant’s school), herein referred to as "Releasor," ______________________________ (name of student participant), herein referred to as “Participant.” Releasor, for and in consideration of student's participation in activities for our 9-12th grade College Visit on Thursday, October 9, 2014 hereby agrees to release Northern Kentucky University, herein referred to as "NKU", and the Educational Talent Search Program, their officers, agents, employees, successors and assigns from any and all liability for any and all loss or damage, and any claim or damages to the Participant arising out of, or in any way relating to participation in said tours, and will for his or her heirs, assigns and agents save and hold harmless NKU and the Educational Talent Search Program from any and all claims and/or causes of action arising out of, or in any way relating to said field trip. In case of a medical emergency, Releasor hereby authorizes NKU and/or the ETS program staff to contact Dr. ______________________________ (Doctor’s name) at ______________________________ (Doctor’s phone number.) If said Dr. cannot be reached, Releasor authorizes NKU and/or ETS to obtain medical care for the Participant from the nearest medical facility. If an emergency situation arises, Releasor authorizes NKU and/or the ETS staff to contact ______________________________ (relative/friend) at ______________________________ (relative/friend’s phone number), whose relationship to the Participant is ______________________________ (relationship). Releasor discloses the following list of medical problems which might require medication or special attention during the Educational Talent Search Program field trip: _____________________________________________________________________ Releasor agrees that photographs of students taken during the tours may be used by Educational Talent Search in reports, public information, and educational materials. Releasor expressly agrees that this release and waiver agreement is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Kentucky, and that if any portion of this agreement is held invalid, Releasor agrees that the balance shall; notwithstanding, continue in full legal force and effect. Releasor affirms that he or she is eighteen years of age or older and legally competent to sign this release agreement; and that Releasor has read this release agreement, understands the terms herein are contractual and not a mere recital and that by signing this agreement the Releasor agrees to all of its terms. In witness thereof, Releasor has executed this release on the day and year first above written. ________________________________ Signature of Parent/Legal Guardian