SUMMER HUMANITIES AND ENGINEERING ACADEMY AT COLUMBIA UNIVERSITY TEACHERS COLLEGE

ACKNOWLEDGEMENT & RELEASE

In consideration of The Trustees of Columbia University in the City of New York (the “University”), Columbia University, Teachers College (“TC”), Elite Direction Inc. (the “Company”) and any of its agents, employees, or contractors permitting the undersigned to enter the premises of the Columbia University Teachers College Summer Humanities & Engineering Academy (the “Program Location”) on 7/20/19 for the purpose of participating in the Columbia University Teachers College Summer Humanities & Engineering Academy (“the Academy”), the undersigned hereby acknowledges and agrees, as follows:

I am fully aware that the Columbia University Teachers College Summer Humanities & Engineering Academy may involve dangers or risks directly or indirectly related to my participation in the Academy, including, but not limited to, the possibility of physical injury (including allergic reactions and death). I am in good health and have no pre-existing medical condition(s) that would prevent me from participating in the Academy.

I expressly assume all risks relating to my participation in the Academy whether or not arising out of the negligence of the University, TC, the Company, and/or any other Releasee (as defined in paragraph 3 below) or otherwise.

I hereby forever release and discharge The Trustees of Columbia University in the City of New York, Columbia University, Teachers College, Elite Direction Inc. their respective owners, parent companies (whether direct or indirect), affiliated entities, partners, directors, officers, agents, employees, contractors, successors and assigns of any of the foregoing (collectively referred to as the “Releasees”) from, but not limited to, any personal injury, death, or property damage and against any and all causes of action, claims, suits, controversies, agreements, promises, judgments, demands or claims whatsoever, that I, or my heirs, executors, administrators, successors or assigns have or hereafter, at any time, shall or may have against the Releasees, arising out of or in connection with (i) my participation in the Academy whether or not arising out of the negligence of the Releasee or otherwise. I further agree to indemnify, defend, and hold harmless the Releasees for any injuries, damage, illness, death, claims, damages or causes of action relating to or arising out of the Academy.

I hereby allow The Trustees of Columbia University in the City of New York Columbia University, Columbia University Teachers College and Elite Direction to use photographs, videos, and/or commentary for program evaluation and promotional purposes, without compensation, notification or permission, and grant to the Releasees any and all rights to said use. I understand my student’s name(s) will not be published.

A copy of this form will be filed electronically for at least three years after the activity has concluded. Please note that this form contains confidential information and should be handled accordingly.

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