___________, 2007.
____________________________________, of __________________, Oklahoma, hereinafter referred to as
Releasor, for good and valuable consideration, does for himself/herself and personal representatives, heirs,
executors, administrators, assigns and next-of-kin, hereby release, waive and forever discharge, indemnify,
agree to defend and covenant not to sue the Board of Regents of the University of Oklahoma, its officers,
regents, employees, agents, and representatives, hereinafter collectively referred to as Releasees, and their
heirs, personal representatives, and next-of-kin, for any and all losses, damages, claims, demands, actions or
rights of action of whatsoever kind or nature, either in law or in equity, arising from or by reason of any bodily
injury or personal injury, known or unknown, death and/or property damage resulting, or which may occur as a
result of traveling to and from ________________________________, hereinafter referred to as the Field
Trip to visit ______________________________________________________________________________ .

Further, I recognize and acknowledge all of the potential risks and dangers of the activities which may occur
while traveling to and from, attending and participating in Field Trip, including hiking across rough terrain
and climbing in hilly or mountainous terrain and other activities related to petroleum and geological studies, but
hereby acknowledge and state that all my activities associated with and/or related to attending Field Trip are
entered into as free and voluntary acts with full and complete knowledge of the risks involved.

I recognize that for any field trip there are inherent risks and hazards directly or inherently involved, such as
vehicle travel or physical activities within outdoors field sites. With full knowledge of the facts and
circumstances surrounding these Activities, I voluntarily undertake these Activities and assume all responsibility
and risk from my participation in these Activities, including all risk of loss of limb or life, property damage,
injury to others, and other hazards to me.

I understand that the University of Oklahoma does not insure students and strongly recommends that all students
obtain their own health insurance as necessary to provide for and pay any medical costs that may directly or
indirectly result from participation in these Activities.

I assure the University of Oklahoma that there are no health-related reasons or problems which preclude or
restrict my participation in these Activities. I further assure the University that I shall abide by all rules, policies
and regulations associated with the Activity and/or requested of me by the University.

I have read and understand the OU Student Code of Responsibilities and Conduct for the
Norman Campus (http://www.ou.edu/studentcode/OUStudentCode.pdf) and agree to abide by
all the provisions cited therein. I understand that this Release contains the entire agreement
between the parties hereto and the terms of this Release are contractual and not a mere recital.
Furthermore, I have carefully read the foregoing Release and know the contents there of and
sign this Release as my own free and voluntary act.


Student/Releasor: _______________________________________________ Date: ______________________

Witness: ______________________________________________________ Date: ______________________

Course Title, Number, & Section: ______________________________________________________________

Emergency Contact Information: Person to contact: _______________________________________________

Relationship to Participant: ________________________________ Phone Number: ____________________

Address: __________________________________________________________________________________