ACE Day Participant Form 2021
Thank you for your interest in Ada Community Engagement (ACE) Day 2021! We are excited to have you join us!

Saturday, August 21, 2020 - 8:30am-12:30pm. At the end of registration, you will receive a link to sign up for the specific time and site you would like.

You will receive a nametag, a t-shirt to wear for the service project and information regarding your site for the day. Please dress appropriately for the service projects as all are outside and be sure to wear closed toe shoes. All individuals who volunteer for the day will receive a voucher for free ice cream from 3 Brothers Pizza!

Please refer any questions to onuaceday@onu.edu.
Email *
WAIVER OF LIABILITY, INDEMNIFICATION, AND MEDICAL RELEASE
Are you under 18 years of age? *
If you are under 18 years of age, please complete this form to register for ACE Day: In addition, your parent/guardian will need to complete the form and then submit to onuaceday@onu.edu in order to finish your registration:  https://bit.ly/ACEDay21Minor
Acknowledgment and Assumption of Risk: I am aware of the dangers and risks to my person and property involved with participating in Ada Community Engagement (ACE) Day 2021 (the “Activity”). **I understand that this Activity involves certain risks of property damage, bodily or psychological injury, or death.  I also understand that participating in this Activity involves potential risks of which I may not presently be aware.  Because of the inherent dangers of participating in this Activity, I recognize the importance of and agree to fully comply with all applicable laws, policies, rules and regulations, and any supervisor’s instructions regarding participation in this Activity. **I represent that I have no medical, physical, or emotional condition which may adversely affect my participation in this Activity, or which may cause me to be a danger to myself and others.  I understand that it is my responsibility to determine my suitability for participation in this Activity.  I agree that I will not consume or be under the influence of any chemical substance other than one prescribed by a licensed medical practitioner and taken in a manner consistent with that practitioner’s orders during my participation in the Activity. **I understand that Ohio Northern University (“ONU”) has no responsibility or liability for property damage, bodily or psychological injury, or death resulting from my participation in this Activity. **I understand that ONU does not insure participants engaging in the above-described Activity, and that any insurance coverage would be through personal insurance. **I voluntarily elect to participate in this Activity with knowledge of the danger involved, and I hereby agree to accept and assume any and all risks of property damage, bodily or psychological injury, or death. *
Required
Waiver of Liability and Indemnification: In consideration for being allowed to voluntarily participate in the above-referenced Activity, on behalf of myself, my personal representatives, heirs, next of kin, successors and assigns, I forever: **waive, release, and discharge ONU and its agents, officers, employees, trustees, heirs, successors, and assigns, from any and all negligence and liability for my death, disability, bodily or psychological injury, property damages, property theft or claims of any nature which may hereafter accrue to me and my estate as a direct or indirect result of my participation in the above-referenced Activity; and agree to defend, indemnify, and hold harmless ONU and its agents, officers, employees, trustees, heirs, successors, and assigns, from and against any and all claims of any nature including all costs, expenses and attorneys’ fees, which in any manner result from my or any other participant’s actions during this Activity. *
Required
I hereby consent to receive medical treatment which may be deemed advisable in the event of bodily or psychological injury, accident, or illness during this Activity, and I authorize ONU to provide a third-party medical caregiver with information regarding my medical history as may be deemed important.  This release, indemnification, and waiver shall be construed broadly to provide a release, indemnification, and waiver to the maximum extent permissible under applicable law.  I, the undersigned participant, affirm that I am at least 18 years of age and am freely signing this release, indemnification, and waiver (“Agreement”).  I have read this Agreement and fully understand that by signing this Agreement I am giving up legal rights and/or remedies which may otherwise be available to me regarding any losses I may sustain as a result of my participation in the Activity.  I agree that if any portion of this Agreement is held invalid, the remainder will continue in full legal force and effect. *
Please type your full name to acknowledge as this will serve as your signature.
First Name *
Last Name *
Cell Phone Number *
Format: 123-456-7890
T-Shirt Size *
Do you have any physical limitations or allergies? *
Please provide any details. If not, please indicate NONE.
I am a: *
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