I, the undersigned, am employing ASPIRE for the purpose of instruction. In consideration for this instruction I hereby release ASPIRE and its agents and employees, and agree to hold them harmless from any and all liability, claims, damages, actions and cause of action whatsoever, for loss, damages or injury to person or property, irrespective of how arising and however caused, including but not limited to all kinds and degrees or extent of negligence with which ASPIRE, its agents or employees may be charged in connection, directly or indirectly with those volunteering to be a demonstration patient. I further agree to disclose in writing below, all of my physical and medical conditions, limitations and sensitivities, and agree to release and hold ASPIRE, its agents and employees harmless from any liability, claims, damages, actions and causes of action in any way relating to or arising from said conditions, limitations or sensitivities. I further agree that ASPIRE, its agents and employees shall not be liable for any claims, demands, injuries, damages, actions or causes of action whatsoever arising out of, or connected with the use of any of its services, facilities or equipment. I hereby expressly forever release and discharge ASPIRE, its agents and employees from all such claims, demands, injuries, damages, actions or causes of action, and from all acts of active or passive negligence on the part of ASPIRE, its agents and employees.
I consent to the taking of photographs, motion pictures, videotapes and to the preparations of other graphic materials, including various social media, where appropriate by Andrews University, Department of Physical Therapy, and ASPIRE OMT for the purpose of class instruction and demonstration.
While participating in this activity, I agree that the department may use or permit other persons to use these prepared negatives or prints. I realize that this documentation may be used in the future for presentations or in scientific or medical publications and reports.
