6/26/2014 11:32:02 AM::Viterbo Emergency Test #3. No action required.

6/26/2014 11:30:15 AM::Viterbo test message #2. No action required.

This is a test.

Physical Plant

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Student Driver Waiver and Release Form

The undersigned Viterbo University student expressly agrees, and by these presents does hereby agree, to hold harmless and indemnify Viterbo University, Inc. and its employees for any damages or claims which such student may cause to any property, of any nature whatsoever, occurring during any field trip. It is further understood that Viterbo University, Inc. and its employees shall not be responsible for any loss of personal possessions during participation in such field trips.

The undersigned agrees and understands that Viterbo University and its employees shall not be liable for any injuries or claims incurred by such student on any field trip when such student is not expressly under the control or supervision of a member or duly authorized person of Viterbo University, Inc.

It is expressly understood that any student participating in any field trip shall do so of his or her own free will.

When completed, return to the Physical Plant Department.

Dated this ______ day of ___________________, 20___

Name _______________________________________________________________