Lactation Accommodation Program
Program Registration & Questionnaire
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  • Lactation Plans

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  • Lactation Room Choices

  • Waiver of Liability, Assumption of Risk & Indemnity Agreement

    Wavier: In consideration of being permitted to participate in any way in the UCSB lactation accommodation program, in which I may use mechanical/electrical devices that could cause bodily harm, including death, or property damage because of the inherent risk of mechanical malfunction or electrical shock hereinafter called “The Activity”, I, for myself, my heirs, personal representative or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the University of California, its officers, employees, and agents from liability from any and all claims including the negligence of The Regents of the University of California, its officers, employees and agents, resulting in personal injury, accidents, or illnesses (including death) and property loss arising from, but not limited to, participation in The Activity.

    Assumption of Risks: Participation in The Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions 3) catastrophic injuries including paralysis and death.

    I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in The Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.

    Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD The Regents of the University Of California HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in The Activity and to reimburse them for any such expenses incurred.

    Severability: the participant further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

    Acknowledgment of understanding: I have read this waiver of liability, assumption of risk and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am entering the agreement freely and voluntarily, and intend by clicking "Yes" to be a complete and unconditional release of all liability to the greatest extent allowed by law.