Student Internships Release Form
Please read this form carefully. Note that by signing this waiver and release and participating in
the internship described below (the "Activities"), you will be expressly assuming the risk and
legal liability and waiving and releasing all claims for injuries, damages, or loss which you might
sustain as a result of any and all activities connected with and associated with the Activities.
SFA SPONSORING DEPARTMENT: _____________________________________________
SUPERVISOR OF INTERN (Print Name): __________________________________________
INTERN (Print Name): __________________________________________________________
ADDRESS: ___________________________________________________________________
PHONE NUMBER: ____________________________________________________________
DESCRIPTION OF INTERN’S ACTIVITIES: _______________________________________
______________________________________________________________________________
______________________________________________________________________________
LOCATION: ____________________________________ DATES: ____________________
I, the above named intern, am 18 years of age or older, and am performing as an intern at SFA of
my own free will. I acknowledge that within the course and scope of my activities as an intern, I
may be exposed to hazards or risks that may result in my illness, personal injury, or death and I
understand and appreciate the nature of such hazards and risks. In consideration of being
permitted to participate in the Activity, I hereby accept all risk to my health, including any injury
or death, and property that may occur while I am acting within the course and scope of the
Activity as an intern or otherwise participating in the Activity. To the best of my knowledge, I
can fully participate in this activity.
I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Stephen F.
Austin State University, the Board of Regents, the State of Texas, their officers, servants, agents,
and employees (hereinafter referred to as RELEASEES), from any and all liability, claims,
demands, actions and causes of action whatsoever arising out of or related to any loss, damage,
or injury, including death, that may be sustained by me, or to any property belonging to me,
WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise, while
interning or otherwise participating in the Activity, or while in, on or upon the premises where
the Activity is being conducted or in transportation to and from said premises.
I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS RELEASEES from any
loss, liability, damage or costs, including court costs and attorneys’ fees they may incur due to