List Insurance Company and Group Number
1. Inherent Risks - I understand and acknowledge that there are known, unknown, and unanticipated risks and dangers that are qualities of these activities that cannot be eliminated. These are often called “inherent risks” and will be referred to this way in this document. Some of the activities that I may be participating in:
Participants will drive to and from outdoor sessions in the Alaska Range. Activities include, but are not limited to: skiing with a variety of equipment, snowshoeing, hiking, winter camping, backpacking, rappelling, climbing ropes, belaying, knottying, working with ropes, and simulating falls.
Weather: Alaska temperatures may range from 60 to -100 degrees Fahrenheit along with blizzards, snow/ice, high winds, and long periods of sun exposure. Participants may experience dehydration, sun burn, wind burn, eye irritation, frost bite, hypothermia, and potentially death.
Terrain: The sites are primarily undeveloped wilderness with no medical services nearby. Participants will hike with crampons/ice axes over uneven terrain, steep exposed slopes, glaciers with unforeseen cracks/crevasses; frozen/flowing water, and possible avalanche areas. Potential risks of injury include sprains/strains, bruising, fractures, concussions, lacerations, and potentially death associated with avalanches, flowing water, slips, trips, and falls, and drowning.
Wildlife: Participants may encounter moose, bears, foxes, and other mammals with a potential risk of bites, scratches, infection, and a low risk of major injuries or death. Nuisance creatures include mosquitos, bees, wasps and other insects along with squirrels, marmots, birds. Bites, rash, and anaphylactic shock (if participant is allergic) are potential risks.
Travel: Participants may encounter potential risks when traveling by car. Unforeseen accidents could result in fractured bones, contusions, concussions, scrapes, puncture wounds, and potentially death.
General Safety: There are potential risks of burns and cuts while using camp stoves or campfires; fatigue and back strain from heavy packs; illness from consumption of untreated water/spoiled food; hyperventilation, burning of skin, shortness of breath, and swelling membranes from bear spray; and rope burns/abrasions from rappelling and climbing activities.
2. Possible Harms - I understand that these “inherent risks” can result in “harms,” which in this document means damage to property or permanent or temporary physical, emotional, and mental injury to or death or disability.
3. Investigate Risks - I agree that it is my responsibility to understand the risks in my participation in this activity. It is my responsibility to investigate the risks if I do not fully understand these risks.
4. Assumption of Risk - After considering the “inherent risks” and “harms” that may result, I voluntarily assume all “inherent risks” that I may encounter during participation in or transportation to, from or as a part of this activity, and I agree to be financially responsible for any “harms” that result.
5. Negligence - I also recognize that while the University will not knowingly or intentionally cause or permit “harms” to occur, the same or similar “harms” such as those mentioned in paragraph 2 may be caused by the negligence or fault of University of Alaska employees, its agents or volunteers or by fellow participants.
6. Release - I further agree to release the University of Alaska, its Board of Regents, officers, agents, and employees (hereafter “University”), from all liability and claims of any kind, for any “harms” to me arising from the negligence of University of Alaska employees, its agents or volunteers, or of fellow participants. This includes claims for loss, expense, damages, punitive damages or attorney fees, or loss of companionship or support of family.
7. Indemnity and Hold Harmless - I agree to indemnify and hold the “University” harmless if I or anyone else brings claims against the “University” to recover damages of any kind for “harms” to me arising from the negligence of University of Alaska employees, volunteers or of fellow participants, or from our participation in, or transportation to, from or as a part of this activity. This means that I will be responsible for attorney fees and expenses incurred by the “University” in its defense of claims and any damages awarded against the “University.”
8. Other Providers - I understand that my assumption of risk, release and indemnification of the University apply regardless of whether this activity is operated, sponsored, or hosted in whole or in part by the University of Alaska or a third party.
9. Accommodations - I certify that I am in good health and I know of no medical reason why I am not able to participate. If I have a disability, food or drug allergy, dietary requirements or any other condition requiring accommodation, I will contact the activity director at least fourteen (14) days prior to the start of the activity.
10. Consent to Care - I consent to first aid, emergency medical care, and if necessary admission to a hospital for care and treatment for injuries or illness anytime during this activity.
11. Financial Responsibility - I understand that I am responsible for obtaining insurance and for any expenses that arise out of medical care. Upon my request and at my expense accident insurance may be available to me through the University.
12. Compliance with Rules - I agree that I will abide by all University policies, regulations, and procedures and by all local, state and federal laws. If I fail to abide by these rules and laws, that may be a basis for denying or ending my participation in this activity.
13. Others Affected - I intend that this Agreement is and will be binding on my family, estate, heirs, successors, assigns, insurers, medical providers and personal representatives.