RELEASE AND INDEMNITY AGREEMENT

I, _______________________________, a student at North Carolina Wesleyan College, hereby expressly acknowledge that I am 18 years of age or older, and that as a part of my education at North Carolina Wesleyan, I may take part in certain activities outside the classroom, including but not limited to accompanying law enforcement officers in the performance of their duties, which may expose me to certain dangers inherent in such activities

In consideration for North Carolina Wesleyan's making such opportunities available to me, I, for myself, my heirs, personal representatives and assigns, (1) do hereby expressly release, acquit and forever discharge North Carolina Wesleyan College, Incorporated, its officers, trustees, employees, agents, successors and assigns, from any and all claims for injuries (including death) or damages caused by, arising out of, or in any way related to, my participation in any activities outside the classroom including but not limited to participation in internships and co-ops; and (2) do hereby expressly agree to hold harmless and fully indemnify North Carolina Wesleyan College, Incorporated and all other persons herein released from any and all losses from any such claims.

Executed this_____day of__________________________________, 20____, under seal with the intent that this shall be a "sealed instrument."

Student Signature___________________________________________(SEAL)

Printed Name of Student _____________________________________

Signature of Witness_________________________________________

Printed Name of Witness______________________________________