Omega Psi Phi Fraternity, Inc - Download as DOC

							                                                                         FORM 9A-20 (a)

                     AFFIDAVIT OF CHAPTER MEMBER

STATE OF                   }
COUNTY OF              }

    Before me, the undersigned official, on this day personally appeared
             , who is personally known to me, and first being duly sworn according to
law upon his oath deposed and said:

“My name is                 ; I am over the age of 18 years and I reside at
                 . I have never been convicted of a crime, and I am fully competent to
make this affidavit. I have personal knowledge of the facts stated herein, and they are
all true and correct.”

               Every affiant acknowledges that he:
               (a)    understands all Fraternal rules on Membership Selection,
               (b)    Are not agents of Omega.
               (c)    Do not have any authority to process members into the Fraternity,
               (d)    Have not hazed any individuals who are proposed for
                      membership selection and that there has not been any
                      underground pre or post processes conducted.
               (e)    Agree to a lie detector test, if requested.

               1. DEFENSE HOLD HARMLESS AND INDEMNITY CLAUSE

        It is the specific and express intent and the agreement of the parties hereto that in
the event the Affiant hereto should cause either directly or indirectly, damage, loss,
destruction, liability or claims against the Omega Psi Phi Fraternity, Inc. from any and
all obligations, liabilities, causes of actions, lawsuits, damages, assessments, including
legal fees, etc. as a result of said affiant’s intentional actions or negligence.

       This indemnification clause shall survive this Agreement and shall be
enforceable as a separate cause of action in the event necessary.


               2. PARTIES BOUNCE CLAUSE

        This agreement shall be binding upon and inure to the benefit to
the parties hereto, their respective heirs, executors, administrators,
legal representatives, successors and assigns.
        The affiant hereto expressly agree that in the event he seeks to or
does transfer any and all, or part of his assets to a separate entity, not a
                                                                       FORM 9A-20 (a)

party to this agreement, said Affiant shall be liable under this Agreement as
if said transfer had not occurred.

                3. REPRESENTATIONS
        No representations, promise, guarantees or warranties were made
to induce either party to execute this Agreement other than those stated in the
Agreement.
        If any provisions of this Agreement shall for any reason be held
Violative of any applicable law, governmental rule or regulation, or if said
Agreement is held to be unenforceable or unconscionable, then the
invalidity of such specific provision herein shall not be held to invalidate
        The remaining provisions of this Agreement. Such other provisions and
The entirety of this Agreement shall remain in full force and effect unless
the removal of said invalid provisions destroys the legitimate purpose of
this Agreement shall be null and void.

               4. STATE LAW AND VENUE DETERMINATION

        This Agreement shall be subject to and governed under the laws of
the State of Georgia. Any and all obligations and payments are due in
performable and payable in Dekalb County, Georgia.

      The parties hereto agree that venue for purposes of any and all
Lawsuits, cause of actions, arbitration’s or other disputes shall be in
Dekalb County, Georgia.


                                                 ________________________________
                                                        Affiant


       On                          , 20 , personally appeared                     , and
having been duly sworn by me, subscribed to the foregoing affidavit
And has stated that the facts stated therein are true and correct.

                                             _______________________________
                                             Notary Public


                                             My Commission Expires:


                                             _____________________________

                                             ___________________________
                                              Notary Name Printed