Participant Consent Form (Summer Bridge)

Name(Required)

First Last

Email(Required)

I understand that St. Olaf College and the SSS Summer Bridge Program have no obligation to provide health, accident, disability or hospitalization insurance for me.(Required)

Yes

I hereby release and discharge the Student Support Services Program and St. Olaf College, its regents, officers, employees, agents, successors and assigns from any and all claims and liabilities arising out of my participation in the Student Support Services Program.(Required)

Yes

I agree without limitation to indemnify, defend and hold harmless the Student Support Services Program, St. Olaf College, its regents, officers, employees, successors and assigns from any and all claims and liabilities asserted by or on behalf of myself arising out of my participation in the Student Support Services Summer Bridge Program.(Required)

Yes

This waiver will be governed by the laws of the State of Minnesota. I have read this waiver carefully and I understand and agree to be bound by the provisions of this waiver.(Required)

Yes

Date(Required)