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:
Driving to and from outdoor sessions in the Alaska Range; Skiing using a variety of equipment types and techniques that currently may be foreign to me; Snowshoeing; Travel while wearing crampons; Travel
while carrying and using ice axes; Self-arrest and otherwise stopping falls using an ice axe; Travel in
remote locations with no emergency medical personnel; Travel while carrying heavy backpacks; Knot tying and rope-work; Rappelling; Hanging from ropes; Climbing up and down ropes using my own
strength; Simulating falls while attached to ropes; Simulating falls while not attached to ropes; Belaying or otherwise supporting my weight and/or other persons’ weight using ropes and anchors; Relying on temporary anchors in snow and ice to support my weight and others’; Falls, unintentional and simulated; Traveling on uneven terrain; Travel on exposed slopes of various degrees; Travel in areas where
avalanches are possible, have occurred, and have killed others; Travel on glaciers where crevasses and
unforeseen cracks may be present and have killed others; Travel on ice and snow; Travel across flowing
water; Travel across frozen water; Travel on terrain that contains unknown and unknowable dangers;
Winter camping, including sleeping in extreme cold; Travel in extreme temperatures, including extreme
cold, windchill, and extreme sun exposure.
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.
By my signature, I agree and represent that: I have entered into this Agreement on the basis of my own
assessment of the risks involved and not in reliance upon representations of the University, its employees, officers or agents; I understand that I have the right to consult an attorney of my choice before signing this Agreement; I further understand that this Agreement contains our entire agreement, and that it cannot be modified except in a writing signed by me and the University; Alaska law applies to this Agreement and any dispute will be resolved in the state court located in Fairbanks, Alaska; If any part of this Agreement is found to be invalid or unenforceable for any reasons, the balance of the Agreement remains valid and enforceable; This a legally binding agreement designed to protect the “University” from claims that could be brought by myself or anyone else because of “harms” to me.