SIU Forestry Field Days Volunteer Name(Required) First Last Email(Required) Participant Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Choose what you would like to volunteer for: Chainsaw Safety and Operation - 2 more volunteers needed Waiver & Release AgreementRisk of Injury(Required)Risk of serious bodily harm, injury, paralysis, or death, as well as damage to my equipment and personal property, may occur with respect to my participation in the IAA/SIU Student Field Day, including, but not limited to, activities related to climbing, aerial lifts, the use of equipment and facilities. I acknowledge and accept the Risk of Injury described above.Assumption of Risk(Required)I accept and assume the risks, known and unknown, related to my participation in the IAA/SIU Student Field Day, including, but not limited to, injury or damage arising from, or related to, the negligence or actions of the IAA, SIU and other parties. I acknowledge and accept the Assumption of Risk described above.No Physical or Medical Limitation(Required)I am unaware of any disease, injury, or any other physical or medical condition that would impair or limit my ability to participate in the IAA/SIU Student Field Day. I understand that IAA encourages all participants to maintain appropriate health insurance throughout their participation in the IAA/SIU Student Field Day because of the risks of serious injury. I confirm I have no physical or medical limitations as described above.Release of Claims(Required)I release and discharge the IAA and SIU, their officers, directors, members, employees, volunteers, representatives, and respective successors and assigns (“Releasees”) from and against any present and future loss, damage, action, liability, or claim (“claims”), known or unknown, relating to or arising from my participation in, or association with, the IAA/SIU Student Field Day. I agree to the Release of Claims described above.Indemnification(Required)I will indemnify, defend, and hold the Releasees harmless from and against any loss, damage, claim, demand, action, judgment, fine, penalty, or liability, including costs and attorney fees, incurred by the Releasees resulting from, arising out of, or related to my participation, involvement, or association with, the IAA/SIU Student Field Day. I agree to the Indemnification terms described above.Insurance(Required)I understand that IAA/SIU strongly advises all Student Field Day participants to maintain personal health insurance throughout their participation in any IAA/SIU Student Field Day. IAA has also advised that it currently maintains a supplemental medical insurance policy on behalf of participants in IAA/SIU Student Field Day. This supplemental medical insurance policy may provide a benefit up to $250,000 (USD) for medical costs associated with an injury sustained during participation in the IAA/SIU Student Field Day. I further understand and agree that this medical insurance policy is: (a) applicable only to IAA/SIU Student Field Days that occur in the United States and Canada; (b) conditioned on my compliance with, and satisfaction of, the terms and conditions of all Agreements between IAA and the insurance carrier, and the insurance policy; (c) supplemental and secondary to my own personal health insurance; and (d) limited only to eligible costs in excess of my personal insurance benefits, and may not apply to co-pays, deductibles, and other insurance costs. I further understand and agree that IAA/SIU does not covenant, agree, or promise to continue to provide the supplemental medical insurance policy, and it may cancel such policy at any time. I acknowledge and understand the Insurance provisions described above.Compliance with Event Rules(Required)I will comply with and abide by all rules and regulations issued or adopted by the IAA and SIU related to the IAA/SIU Student Field Day, including, but not limited to, instructor and facilitator direction and all instructions, rulings, and directions of IAA volunteers and onsite personnel. I agree to comply with all Event Rules as described above.Agreement Term(Required)This Participant Agreement and Release will remain valid for twelve (12) months from the date I have signed below and applies to all IAA/SIU Student Field Days held during that period, or until such time as I expressly revoke the Agreement in writing delivered to the IAA. I understand that if I revoke the signed Agreement, it will apply only to future events and not those that occurred prior to notification. I understand that I will not be permitted to participate in any IAA/SIU Student Field Day upon revocation of this Participant Agreement and Release. I acknowledge and agree to the Agreement Term described above.Governing Law(Required)This Participant Agreement and Release will be governed by and construed in accordance with the laws of the State of Illinois. To the extent permitted by governing law, I hereby waive any applicable law, rule, or regulation that would invalidate or otherwise limit any term of this Participant Agreement. If any court of competent jurisdiction determines any term in this Participant Agreement to be invalid or unenforceable to any extent, such term(s) shall be severed, and the remaining terms shall remain in full force and effect. I acknowledge and agree to the Governing Law provisions described above.Parties(Required)All of the terms of this Participant Agreement and Release apply to and bind me and my heirs, assigns, personal representatives, and executors. I acknowledge and agree to the Parties provision described above.Final Agreement(Required) I have read and understand the terms and conditions of the IAA/SIU Student Field Day Participant Agreement and Release. By checking the box labeled “I AGREE,” I hereby accept and agree to all such terms and affirm that I am 18 years of age or older. I understand that I am voluntarily giving up legal rights by accepting this Agreement and Release.Date(Required) MM slash DD slash YYYY Signature(Required)
