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To complete your application, you will be required to certify the following:

I hereby certify that I have read and understand the provisions above and agree to assume all risk of personal injury or loss, bodily injury (including death), damage to or loss of, or destruction of any personal property resulting from or arising out of participation in the designated activity. I also release, waive, indemnify, hold harmless, and discharge the University of Å·ÃÀ¿Ú±¬ÊÓƵ from all claims, damages, and injuries arising out of my activities, including my use of equipment and facilities provided by the University of Å·ÃÀ¿Ú±¬ÊÓƵ. I agree to comply with the Å·ÃÀ¿Ú±¬ÊÓƵ Student Code of Conduct and adhere to Section 26 directives for university/public health orders (Å·ÃÀ¿Ú±¬ÊÓƵ students).

In addition to the terms outlined in the Liability Waiver above, I agree to the following conditions:

1. I attest that I am at least 18 years of age.
2. I agree to maintain undergraduate status at Å·ÃÀ¿Ú±¬ÊÓƵ Boulder during the award period.
3. I agree to submit a "PACE Survey" by the deadline in the decision notice.

You will be required to agree to the following liability waiver:

I exercise my own free and voluntary choice to participate in the designated activity. I understand and assume all associated risks of the designated activity.

Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury when participating in any activity/program. Understandably, not all hazards and dangers can be foreseen.

Participants in a Å·ÃÀ¿Ú±¬ÊÓƵ sponsored program must understand that depending upon the particular activity may include but not limited to: dangers and injuries due to natural occurrences beyond human control or influence, exposures to community spread illnesses or diseases, trips, falls, sprains, strains, contusions, lacerations, fractures, broken bones, paralysis, concussions, and all other circumstances inherent to these activities.

Use of a privately-owned vehicle, including the operation or as a passenger, may be an option while participating in the off-campus trip activity. The University of Å·ÃÀ¿Ú±¬ÊÓƵ does not provide liability or physical damage insurance coverage on privately owned vehicles. The vehicle owner must provide the liability and physical damage insurance coverage for a privately owned vehicle.

The University of Å·ÃÀ¿Ú±¬ÊÓƵ does not provide health insurance for individuals participating in activities made available or sponsored by the University of Å·ÃÀ¿Ú±¬ÊÓƵ. As such, you or your personal health insurance will be responsible for payment of medical services and care for any injuries sustained during the designated activity.

You will be asked to agree or decline the following publicity release:

I hereby give permission to the University of Å·ÃÀ¿Ú±¬ÊÓƵ and its agents or employees, to use my name and major, my mentor's name and department/program, and related presentation, performance or exhibition information in any publication which may include printed or electronic media, or both.

I hereby relinquish any right to inspect or approve the completed product or products which may include advertising copy or any other printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the designated information.

I hereby agree to release, defend and hold harmless the University of Å·ÃÀ¿Ú±¬ÊÓƵ and its agents or employees, including any firm publishing or distributing the finished product or products in whole or in part, whether on paper or via electronic media, from and against any claims, damages or liability arising from any misuse of the designated information, either intentionally or otherwise, that may occur or be produced in the production of the finished product, its publication or distribution.