AGREEMENT INCLUDING WAIVER AND RELEASE, ASSUMPTION OF RISKS & INDEMNIFICATION FOR

Harvard Model Congress Asia 2017

This agreement applies to Harvard Model Congress Asia 2017 from January 5-8, 2017.

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS.
PLEASE READ CAREFULLY.

Participant's Name

School Name

Participant's Age:

Parent's/Legal Guardian's Name (Required if under 18 years of age)

By typing my name into the above box, I, the above PARTICIPANT (or if the Participant is younger than 18 years of age, the PARENT or LEGAL GUARDIAN of the above named PARTICIPANT), agree to the following:

RELEASE, WAIVER AND INDEMNITY

In partial consideration for admission into Harvard Model Congress Asia 2017 which is offered by the University of Hong Kong in cooperation with Harvard Model Congress Asia 2017, I agree, on my own behalf and on behalf of the Participant, to release, discharge, indemnify, hold harmless and defend the University of Hong Kong and Harvard Model Congress Asia and staff of Harvard Model Congress Asia and any other covered party and personals from any and all claims, actions, damages, liability, costs or expenses and attorney fees of any spectator, other participant or third party in connection with or arising out of my presence and/or involvement or participation in any activity of Harvard Model Congress Asia 2017.

ASSUMPTION OF RISK

I acknowledge that as in any traveling experience, risk of injury from the activities involved can potentially be significant, including the potential for permanent paralysis, death and serious bodily injury and damage to property. I acknowledge that my presence or the Participant’s presence and any participation in activities of Harvard Model Congress Asia 2017 are strictly voluntary and that there is no one forcing me and/or the Participant to participate in any activities of the conference. I hereby represent that no special relationship exists between me (the Participant) and any of the covered parties and that I am not under any physical, economic or other compulsion to sign this Agreement. On my own behalf and on behalf of the Participant, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my/the Participant’s participation. On my own behalf and on behalf of the Participant, I knowingly and voluntarily assume any and all of the foregoing risks of loss, damage and injury. Additionally, on my own behalf and on behalf of the Participant, I assume responsibility for all damage caused by the Participant to any conference persons or venues, including but not limited to the staff of Harvard Model Congress Asia 2017 and the University of Hong Kong, other conference participants, and the space at the University of Hong Kong and hotels for which a group deal has been arranged with Harvard Model Congress Asia 2017. I certify that the Participant, if under 18 years of age, will be accompanied by me or another adult who will be responsible for supervising the Participant during travel for Harvard Model Congress Asia 2017. I understand that school, delegate, and faculty fees paid to Harvard Model Congress Asia are not refundable, and that cancellation policies for hotel reservations are at the discretion of each participating hotel. HMCA adopts a standard force majeure policy and shall not be held liable for any obligations in the event that acts of God, war, government regulations, disasters, fire, strikes, labor disputes, civil disorder, acts and/or threats of terrorism, curtailment of transportation due to government restrictions or similar cause beyond the control of either party making it illegal or impossible to fulfill the functions of this agreement.

PERMISSION TO USE PHOTOGRAPHS, VIDEOS, IMAGES, QUOTATIONS, AND INTERVIEW FINDINGS

I grant to the University of Hong Kong and Harvard Model Congress Asia, and their representatives and employees the right to publish photographs and video images taken in connection with the above, identified subject. I authorize the University of Hong Kong and Harvard Model Congress Asia, their assignees and transferees to use and publish the same in print and/or electronic form.

I grant to the University of Hong Kong and Harvard Model Congress Asia, their representatives and employees the right to publish quotations and information gathered in connection with the above, identified subject. I authorize the University of Hong Kong and Harvard Model Congress Asia, their assignees and transferees to use and publish the same in print and/or electronic form.

I allow that the University of Hong Kong and Harvard Model Congress Asia to use photographs and video images for any lawful purpose, including purposes such as publicity, advertising and Web content.

I agree that the University of Hong Kong and Harvard Model Congress Asia may use quotations and interview findings for any lawful purpose, including purposes such as publicity, advertising and Web content.

MEDICAL RELEASE

I give consent and permission to the University of Hong Kong and Harvard Model Congress Asia, or a covered party to obtain on the behalf of my minor child, the Participant, or me any emergency medical attention and treatment at my sole expense. I certify that I have adequate insurance to cover any injury or damage that I/the Participant may cause or suffer while participating, or else I agree to bear the costs of such injury or damage to the Participant or me. I further certify that I am willing to assume the risk of any medical or physical condition the Participant or I may have. In the event that I cannot be reached in an emergency, I hereby give permission to any the University of Hong Kong or Harvard Model Congress Asia employee and any licensed physician, surgeon, clinic or hospital to secure/seek proper treatment and to order anesthesia for the Participant or me as named above.

I HEREBY CERTIFY THAT I AM OVER 18 YEARS OF AGE OR I AM HAVING MY PARENT/LEGAL GUARDIAN SIGN THIS DOCUMENT. I HAVE CAREFULLY READ AND HEREBY AGREE TO THE ABOVE TERMS AND CONDITIONS. PRIOR TO SIGNING THIS AGREEMENT, I HAVE REVIEWED THE CRITICAL THINKING SCHEDULES AND ACTIVITIES AND HAVE HAD THE OPPORTUNITY TO ASK ANY QUESTIONS. I AM AWARE THAT BY SIGNING THIS AGREEMENT, I, ON MY OWN BEHALF AND ON BEHALF OF THE PARTICIPANT, ASSUME ALL RISKS AND WAIVE AND RELEASE CERTAIN SUBSTANTIAL RIGHTS THAT I, MY HEIRS, NEXT OF KIN, FAMILY, RELATIVES, GUARDIANS, EXECUTORS, ADMINISTRATORS, TRUSTEES AND ASSIGNS OR THE PARTICIPANT MAY HAVE OR POSSESS AGAINST the University of Hong Kong AND HARVARD MODEL CONGRESS ASIA.

*PERSON SIGNING THIS FORM ACCEPTS FULL RESPONSIBILITY FOR PARTICIPANT*

Electronic Signature of Participant:
Note that typing one's name into this box constitutes a legal signature and certification of the above.

Date (mm/dd/yyyy format)

Date of Birth of Participant (mm/dd/yyyy format)

Age:

Electronic Signature of Parent/Guardian:
Note that typing one's name into this box constitutes a legal signature and certification of the above.

Date (mm/dd/yyyy format)

Emergency Phone Numbers:
(cell)

(alternate)

Participant's Legal Address