iMakerSpace Acknowledgement, Release, Indemnification and Consent to Medical Treatment

Questions? Email the iMakerSpace imakerspace@tntech.edu

Use of iMakerSpace facility, equipment, and tools

I understand that there may be risks associated with my participation in this activity and that such risks could result in loss, damages, injury or death. In addition to the general risks inherent in all activities (e.g.,travel risks, premises risks, bodily injury risks, equipment risks and unforeseeable risks), I acknowledge that this activity may present specific risks including but not limited to the following:

Injury due to improper use of equipment/tools such as, but not limited to: hammers/nails, screwdrivers, utility knives, power tools, equipment with rotating parts, building materials, saws, chisels, scissors, razor blades; Injury due to, but limited to: flying metal/wood pieces and other debris; Burns resulting from improper use of, but not limited to: 3D printers, soldering irons, heat guns, 3D printing pens, power tools; Electrical shock from, but not limited to: electronics testing equipment, electrical outlets; Blunt force trauma and appendage crushing hazards such as, but not limited to: machinery, vices, presses, drills; Eye, skin, and or respiratory injury from, but not limited to: paper cuts, flying debris, maintenance chemicals and solvents, acetone, lubricants, isopropyl alcohol, photopolymer resin; Injury from improper use of equipment featuring glass such as, but not limited to: glass 3D printer build plates.

I acknowledge that I have had an opportunity to investigate the activity’s requirements and the conditions under which I will be participating in the activity.

I represent that I am physically fit to participate in the activity and that I have adequate health insurance necessary to pay or in the absence of insurance will be financially responsible for paying all amounts or charges for any medical bills that I may incur during the activity. I acknowledge and accept full responsibility for any expenses incurred as a result of such emergency treatment to the extent such expenses are not covered by my insurance. I also agree to indemnify Tennessee Tech for any liability, including attorney’s fees, for any actions brought against Tennessee Tech for any unpaid medical costs or bills I incur.

I grant Tennessee Tech permission to authorize emergency medical treatment if deemed necessary by Tennessee Tech or a medical provider.

I acknowledge that this document will be effective until I revoke it by sending a written notice of revocation to:

Dr. Ismail Fidan
Director, iMakerSpace
LIBR 349
ifidan@tntech.edu

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iMakerSpace Acknowledgement, Release, Indemnification and Consent to Medical Treatment

iMakerSpace Acknowledgement, Release, Indemnification and Consent to Medical Treatment

Use of iMakerSpace facility, equipment, and tools

If you are under eighteen (18) years of age, your parent or guardian mush sign below: