my participation in said Activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES
or otherwise.
It is my express intent that this Intern Release Form shall bind the members of my family and
spouse (if any), if I am alive, and my heirs, assigns and personal representative, if I am not alive,
and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO
SUE above named RELEASEES.
I further understand and acknowledge that SFA is not an insurer of my personal safety or
property. I UNDERSTAND THAT THE UNIVERSITY WILL NOT BE RESPONSIBLE FOR
ANY MEDICAL COSTS ASSOCIATED WITH ANY INJURY I MAY SUSTAIN. I also
understand that I should and am urged by SFA to obtain adequate health and accident insurance
to cover any personal injury to myself which may be sustained during the Activity or the
transportation to and from said Activity.
I further agree to become familiar with the rules and regulations of SFA and not to violate said
rules or any directive or instruction made by the person or persons in charge of said Activity and
that I will further assume the complete risk of any activity done in violation of any rule or
directive or instruction.
IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the
foregoing Intern Release Form, understand it and sign it voluntarily as my own free act and deed;
no oral representations, statements or inducements, apart from the foregoing written agreement,
have been made; I am at least eighteen (18) years of age and fully competent; and I execute this
Release for full, adequate and complete consideration fully intending to be bound by same. I
understand this Intern Release Form will be construed in accordance with the laws of the state of
Texas.
_________________________________________ Date: ________________________
Signature of Intern
_________________________________________ Date: ________________________
Department Head Signature