Cultural Mixer RSVP
LSU & BSU Alpha Omega Collaboration
Student Name/Nombre de estudiante *
Student Email/Correo electronico de estudiante
*
Which club/association are you a member?
De que club o membresia eres parte?
*
How many guests are you inviting? (For Students Only)
A cuantas personas traes a la fiesta? (Solo Para Estudiantes)
*
Do you have any food allergies?
Tiene alergias a los alimentos?
*
I freely choose to participate in this Activity. I understand that I do hereby fully and irrevocably release, waive and discharge Ivy Tech Community College of Indiana (Ivy Tech), its trustees, officers, employees, volunteers, agents and assigns from any and all claims for illness, injuries, including death, to myself or other persons and from any and all claims for damages to my or other persons’ property, arising out of or in any way relating to my participation in said Activity. I further understand that myself, my heirs, representatives, agents and assigns, do hereby fully and irrevocably release, waive and discharge Ivy Tech Community College of Indiana (“Ivy Tech”), its trustees, officers, employees, volunteers, agents, and assigns from any and all claims for illness, injury, including death, to myself or other persons and from any and all claims for damages to my or other persons’ property, arising out of or in any way relating to my participation in such Activity. I agree and understand that participating in such Activity is acceptance of risk of illness, injury, property damage, or death. I acknowledge and understand that participation is voluntary and can include possible exposure to, and illness from infectious diseases included but not limited to MRSA, influenza and Covid. I knowingly and freely assume all such inherent risks, both known and unknown, even if arising from the active or passive negligence of the releasees or others, and assume full responsibility for my participation. I willingly comply with the stated and customary terms and conditions for participation in such Activity as regards to protection against infectious diseases. If I observe any unusual or significant hazard during my presence or participation, I agree to bring the hazard to the attention of the nearest official immediately, and remove myself from participation.

It is acknowledged and understood that I am responsible for the cost of any and all medical and health services I may require as a result of such participation. It is also acknowledged and understood that Ivy Tech disclaims any responsibility for students and others who travel to said Activity in vehicles not owned, leased, or rented by Ivy Tech, and I hereby assume all risks associated with driving myself and/or others, or being driven by others, to or from said Activity. Further, I hereby agree to indemnify and at Ivy Tech’s request, defend and save harmless, Ivy Tech, its trustees, officers, employees, volunteers, agents and assigns from and against any loss, damages, costs, claims or expenses arising from any actual or claimed death or injury to any person or actual or claimed damage to property, whether owned by me, Ivy Tech, or third parties, including loss of use, that actually or allegedly results from my conduct, by act or omission, relating to my participation in said Activity.

In connection with my participation, I grant permission to Ivy Tech and its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/or video images and/or interviews taken of me for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Ivy Tech and its legal representatives for all claims and liability relating to said images and/or interviews. I will make no monetary or other claim against Ivy Tech for the use of the photograph(s)/video and/or interviews.

Please put your full name below. 

*This waiver also covers any guests that you take to the event. 

I HAVE READ AND I UNDERSTAND THIS RELEASE AND AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS.

Por favor escriba su nombre completo a continuacion. 

*Esta exencion tambien cubre a los invitados que lleve al evento.

HE LEIDO Y ENTIENDO ESTE COMUNICADO Y ACEPTO ESTAR SUJETO A SUS TERMINOS Y CONDICIONES.
*
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