I understand that participation in this activity will include but not be limited to the following activities: Travel to and from Belmont University, viewing demonstrations and/or participating in lab activities. I understand that the university does not require me/my child/dependent to participate in this activity, but I/he/she want(s) to do so, despite the possible dangers and risks involved.
3. I recognize that there are risks and hazards directly or inherently involved, making these and related activities potentially dangerous. These include viewing demonstrations and/or participating in lab activities and/or working in a lab setting. With full knowledge of the facts and circumstances surrounding these activities, I voluntarily agree to assume all the risks and responsibilities of my/my child/dependent’s participation in them, including all risk of loss of limb or life, property damage, or injury to others.
4. I, on behalf of myself, my family, heirs and legal representatives release, waive, and forever discharge Belmont University, its agents, employees, officers, and governing board from and against any and all liability, claims and actions that may arise from injury or harm to me/my child/dependent from death or from damage to property in connection with this activity. I understand that this release covers liability, claims and actions caused entirely or in part by any acts or failures to act of Belmont University (or its governing board, employees or agents).
5. I further grant permission for Belmont University, its agents or employees to obtain necessary medical attention in case of me/my child/dependent’s sickness or injury. I consent to any necessary medical examination, diagnosis, or treatment and agree to be responsible for costs of such medical services.
6. I agree that this Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Tennessee, and that if any portion of this Agreement is held invalid, any such findings shall not affect the validity of the remaining provisions which shall remain in full force and effect.
Photo Release
1. I hereby give Belmont University, its employees, licensees, and agents, the absolute and irrevocable right and permission with respect to the photographs, audio recording, and/or video recording taken of me/my child/dependent in which I/my child/dependent may be included with others to:
a. copyright the photograph in the university’s name or university photographer’s name;
b. use, re-use, publish and republish the same in whole or in part, individually or in conjunction with other photographs, in any medium, including the Internet; and
c. use my/my child/dependent’s name and biographical information in connection therewith if so desired.
2. I hereby release and discharge Belmont University, its trustees, officers, employees, licensees and agents from any and all claims and demands arising out of or in connection with the use of the photographs including all claims for invasion of privacy and appropriation.
3. This authorization and release shall also enure to the benefit of the legal representatives, licensees, and assigns of Belmont University as well as the person(s) for whom the photographs is(are) taken.
Pick Up Authorization
I authorize and release the individual(s) listed on the camp registration form to pick up the participant from camp at Belmont University. I understand that individuals authorized for pick up may be required to present valid photo identification in order to pick up the participant. I understand that individuals not listed as parent, legal guardian, emergency contact, or listed on the authorized pick up list will not be permitted to pick up the participant without express written permission provided to Belmont by a parent or legal guardian in advance.
Participant Behavior
Participants enrolled in the camp are expected to follow the rules established by Belmont University for the purpose of safety and smooth operation of the camp. If a discipline problem occurs, the parents/guardians will be contacted by Belmont University. Belmont University reserves the right to end a participant’s participation in a camp when the participant’s behavior affects the safety or well being of camp staff or other camp participants.
Lab Safety Agreement
Anytime that I/my child/dependent am(is) working in or visiting a laboratory at Belmont University, I/my child/dependent will:
1. Know the exact location of all exits to the laboratory and building.
Assumption of Risk and Release Agreement, Photo Release and Lab Safety Agreement Belmont University
2. Determine the location and procedures to operate all safety equipment in the laboratory. Available safety equipment may include: biological safety cabinets, eyewashes, fire blankets, fire extinguishers, first aid kits, fume hoods, safety showers, or spill kits.
3. Notify my laboratory instructor or faculty advisor immediately if I might be pregnant, have an allergy or have any medical condition that could render me particularly susceptible to chemical exposure.
4. Wear closed-toe shoes, appropriate clothing, and any required personal protective equipment when working or observing in the laboratory. Clothing must fully cover the arms, torso, and legs. Required personal protective equipment may include: face shields, gloves, laboratory coats, rubber aprons, or safety glasses/goggles.
5. Secure long hair to avoid accidental damage or loss.
6. Keep the laboratory bench and floor around the work area uncluttered and free from book bags, purses, coats, or other obstructions.
7. Not eat, drink, use tobacco, or apply cosmetics in the laboratory.
8. Never work alone in the laboratory. Work may only be performed during assigned times by my laboratory instructor or my faculty advisor.
9. Come prepared and proceed with care when working in the laboratory. Only work approved by my laboratory instructor or my faculty advisor may be performed.
10. Read reagent bottle and container labels carefully before use. All reagent bottles and containers should be securely closed following use.
11. Exercise extreme caution when working with autoclaves, Bunsen burners, hot plates, or microwaves to avoid burns from hot objects.
12. Immediately report chemical spills, damaged or malfunctioning equipment, and all injuries - no matter how minor - to my laboratory instructor or faculty advisor. Dispose of used or broken materials in proper waste containers according to my laboratory instructor's or faculty advisor’s directions. Waste containers must be appropriately labeled and securely closed when not in use.
13. Clean work areas, common areas, glassware, reusable supplies, and equipment after use. All items should be returned to their proper storage locations following use.
14. Wash hands thoroughly before leaving the laboratory.
I have carefully read the recommended laboratory safety precautions listed. Furthermore, I/my child/dependent agree to carefully follow these and all other safety related instructions, both printed and verbal, whenever I/my child/dependent am(is) in the laboratory. In order to protect myself/my child/dependent or others from harm, I/my child/dependent may be asked to leave the laboratory for violating safety related instructions. If I/my child/dependent am(is) injured or harmed in any way as a result of not following these instructions, I release Belmont University, its agents, employees, officers, and governing board from and against any and all liability, claims, and actions.
I have read this entire Agreement, I fully understand it and I agree to be legally bound by it.