Please fill out the Registration Form and Liability Release completely, and click "Submit Form." If you are not immediately redirected to a confirmation page or if you need more information regarding the form or the event, please contact us us - firstname.lastname@example.org.
I will be 18 years of age by the date of the Labor of Love event. If you are under 18 years of age, you must print this form for your parents to sign. Please FAX - (206) 328–5967 or mail signed release to the Center for Service and Community Engagement.
Name of Emergency Contact
I am a....
Check all applicable:
I am attending with a group -
I would like to be a site leader
Please list any disabilities, special needs, severe allergies, or environmental sensitivities:
If you are under 18 years of age, you must print this form for your parents to sign. An electronic signature will not be accepted. Please FAX - (206) 328–5967 or mail signed release to the Center for Service and Community Engagement.
I hereby release, indemnify and hold harmless Seattle University, its officers, directors and employees, and the organizers, sponsors and supervisors of all 2014 Labor of Love activities from any and all liability in connection with any injury I may sustain (including any injury caused by negligence) in conjunction with the 2014 Labor of Love event. To the extent not insured, I likewise release and hold harmless from liability any person transporting me to or from the 2014 Labor of Love activities.
Signature (type name)
I hereby give to Seattle University, to its nominees, agents and assigns, my free and unlimited consent and permission, waiving all claims for any compensation by reason thereof or for damages by reason thereof, to use, publish, republish or exhibit in the furtherance of its work, with or without identification of me by name, the photographs, videos, or statements taken on this day and to disseminate statements referring to me in conjunction therewith if Seattle University so desires and to authorize any newspaper, company or other organization to use, publish, republish or exhibit said photograph with or without identification of me by name and to publish or disseminate statements referring to me in conjunction therewith in the promotion of Seattle University and any of its fund campaigns or any of its activities.
CODE OF CONDUCT
I understand that the responsibilities and circumstances of an off-campus service opportunity require a standard of professional decorum. Therefore, I indicate my willingness to understand and conform to the standards, policies, and procedures of the Agency. I further understand that it is important to the success of the program and the continuance of future Labor of Love participants that students observe Seattle University’s Code of Conduct, so as not to compromise Seattle University in the eyes of individuals and organizations with which it has dealings, and I acknowledge the Center for Service and Community Engagement’s responsibility for setting rules and interpreting conduct for this purpose. I agree that the University or the Agency has the right to terminate me from my service because of conduct that might bring the program into disrepute or that violates Seattle University or Agency policies. All final resolutions of my academic status in such situations will be made by the University.
Signature (type name)