ࡱ> .0- zbjbjVV 4<<z FF0 NPPPPPP}LPPe NNP :{0@PPF O:  Service-Learning Liability Waiver & Talent Release PARTICIPANTS NAME: __________________________________________________________ (Please Print) SERVICE-LEARNING PROGRAM TITLE: ______________________________________________ COLLEGE OR UNIVERSITY:________________________________________________________ PARTICIPATING AGENCY: _________________________________________________________ Liability Waiver As a service learner, I am providing community services as part of my coursework and not as an agent of _________________(UNIVERSITY), who holds no responsibility and liability for me while I am engaged in this activity. I voluntarily and knowingly assume any risk associated with the service program and waive my right to assert any claim against the participating agency or any of its officers, agents, servants, employees and volunteers for injury, death or damage to my person or property resulting from my participation in this activity. I release and hold harmless _______________ (UNIVERSITY), the State of 鶹Ƶ, all State Departments, Agencies, Boards and Commissions, as well as its officers, agents, servants, employees and volunteers, from any and all claims, demands, causes of action, expense and liability arising out of injury, death or damage to my person or property while participating in this activity. Talent Release I confirm that any and all material furnished and/or performed by me for the above titled activity is either my own or otherwise authorized for such use without obligation to me or to any third party. I also agree to the use of my name, likeness, portrait or pictures, writing, voice, performance, and biographical material about me for academic and program-related promotional purposes. I hereby waive any claim to the rights of photographs or recordings made of me during this activity. I hereby authorize the editing, duplication, reproduction, copyright, exhibition, broadcast and/or non-profit use and distribution of said recordings for purposes deemed suitable by the University. I hereby waive any right to approve the finished products. ____________________(UNIVERSITY) and the UL System reserves full distribution rights to its program and all related materials, through any and all forms of duplication, both in the United States and all foreign markets. __________________________________________________________________________ Signature of Participant (if 18 years of age or older) Date __________________________________________________________ Signature of Participants Parent/Representative (if under 18 years of age) Date "#35v+ / 1 F h    3 K i ɺغqididididididi hhz;\hbFhhz;\h^d8hhz;5CJOJQJaJhhz;5CJOJQJaJhV}hhz;5CJOJQJaJhbFhhz;5CJOJQJaJhhz;CJOJQJaJhbFhhz;CJOJQJaJhhz;5CJOJQJ\aJ"hbFhhz;5CJOJQJ\aJhbv5CJ$\hhz;5CJ$\hhz;%450 1   abgdhz;gdhz;$a$gdhz;$a$gdhz;gdhz;  F Z   # A 6 M N X a f ;`ab;y;yyyqhhz;CJaJhhz;CJOJQJaJh;CJOJQJaJhZ|h;CJOJQJaJhZ|hZ|CJOJQJaJhZ|hhz;CJOJQJaJhbFhhz;CJOJQJaJhbFhhz;5CJOJQJaJ hhhz;hhz; hh hhz; hhz;5\hHhhz;5\*)z$a$gd;$a$gdhz;gdhz;)ACfstyzhoMhhz;CJOJQJ\aJhbFhhz;CJOJQJ\aJhhz;5CJ\21h:p/ =!"#$% j 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ OJPJQJ_HmH nH sH tH P`P hz;Normal(CJOJPJQJ^J_HaJmH sH tH DA D Default Paragraph FontRiR 0 Table Normal4 l4a (k ( 0No List bob hz;Default 7$8$H$-B*CJOJQJ^J_HaJmH phsH tH H`H hz; No SpacingCJ_HaJmH sH tH PK![Content_Types].xmlj0Eжr(΢Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi};~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! 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