Job Shadowing Program Waiver and Release of Liability
Participant Information Name: ______________________________________________________________ Date of Birth: ______________________________________________________ Phone Number: ____________________________________________________ Emergency Contact Name & Phone: ______________________________ Email:________________________________________________________________
STUDENT JOB SHADOW PROGRAM
1. Purpose I understand that I am voluntarily participating in a job shadowing experience hosted by [Company/Organization Name] (“the Company”) for educational and observational purposes only. I will not perform hands-on work unless explicitly permitted and supervised. 2. Assumption of Risk I acknowledge that some job shadowing environments, particularly in trades or industrial settings, may involve risks including but not limited to: exposure to machinery, tools, loud noise, dust, or hazardous materials. I voluntarily assume all risks associated with my participation. 3. Medical Consent In case of a medical emergency and if emergency contact or parent/guardian cannot be reached, I authorize the Company to seek necessary medical treatment. I agree to be responsible for any resulting medical costs. 4. Release of Liability I release and hold harmless the Company, its employees, representatives, and affiliates from any and all claims, liabilities, losses, or damages that may result from or relate to my participation in this job shadowing experience, except in cases of gross negligence or intentional misconduct. 5. Confidentiality Agreement I agree not to disclose any confidential, proprietary, or personal information observed or learned during my time with the Company. 6. Behavior & Conduct I agree to follow all company policies, safety procedures, and instructions from staff. Failure to do so may result in immediate termination of the shadowing experience. 7. Minor Consent (if under 18 years old) Parent/Guardian Name: _________________________________________________________________________________________ Parent/Guardian Signature: _____________________________________________________________________________________ Date: ____________________________________________
8. Participant Signature By signing below, I confirm that I have read, understand, and agree to the terms of this waiver.
Participant Signature: __________________________________________________________________________________________
Date: ____________________________________________
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