EXAMPLE: SHORT FORM PARTICIPATION AGREEMENT In consideration of my being allowed to participate in the [describe TEA], I agree to abide by the following requirements and accept responsibility: 1. Example: attach program information 2. Example: deposit deadlines, refund/cancellation 3. Example: rules of activity Further I acknowledge that my failure to abide by the participation requirements and policies may result in the loss of my deposit money and/or funds paid and other sanctions, such as revocation of my membership privileges, censure, and other sanctions, such as expulsion from the University, my degree program, and/or suspension, dismissal, probation, including my dismissal from the [TEA] and requirement that I return to my home at my expense. I am aware of the inherent risks and dangers associated with this TEA. I agree to accept these risks and dangers. Further, I agree to release, hold harmless and indemnify the University, its employees, agents, and officers for any claims, losses, costs incurred in my failure to abide by the Participation requirements or arising out of my Participation in the TEA. I am 18 years or older: ___________________________________ Signature of Participant Date: ____________________
If Participant is under the age of 18: ON BEHALF OF MINOR: _______________________________________ Signature of Parent/Legal Guardian of Participant Date: _____________
Printed Name: ____________________________________________________ Address: ____________________________________________________ Telephone Number: ________________________________________________ I agree to abide by the TEA requirements and to follow instructions: ____________________________________________________________ Signature of Minor Participant: