CALIFORNIA PARAMEDIC INST 1-2003

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I STUDENT INTERN AGREEMENT This agreement is entered into on who lives at .(" Student") and ,20 between ("City"). Student is enrolled in a course of study at California Paramedic Institute (School) designed to enable Student become a licensed/certified Emergency Medical Technician, Emergency Medical Technician-Paramedic or other similar prehospital health care provider. As part of the cmrieulum, Student has enrolled in the Clinical Experience which is offered through the School, with City's assistance. The Clinical Experience involves: l) Student's performing acquired prehospital skills alongside City's personnel; and, 2) accompanying and observing the City's personnel providing emergency and nonemergency ambulance transport, care and related services. Student has asked to participate in Clinical Experience knowing that participation will require Student to accompany City personnel in dangerous and potentially life threatening situations. Student realizes that City could not, and would not, allow Student to accompany its personnel without his/her agreement to: (I) release the City fi.om any and all claims for injury or death which may result fi.om Student's participation in the program; (ii) assume the risk of death or injury associated with the Clinical Experience; (iii) agree to read, understand and follow City's policies, procedures and guidelines; (iv) act in a professional and respectable manner at all times; and follow the instruction/direction of City personnel with respect to patient care, demeanor, safety, use of personal protective devices, scene control, etc. Student understands that he or she is exposing himself or herself to certain risks inherent in the activities associated with the Clinical Experience. Student hereby represents that he or she AGREES TO ASSUME THE RISKS INHERENT IN THE ACTIVITY. These risks include, but are not limited to, being hurt or injured: (1) by broken glass (or other scene hazards) including various cuts about the head, face, eyes, hands, legs, and torso; (2) by exposure to tetanus or contagious diseases such as the Hepatitis B virus and the Human Immunodeficiency Virus ("HIV"); (3) injury due to gumey lifts and or drops; (4) injury fi.om slip and fall type incidents; (5) various strains and/or sprains to one and/or all muscle groups; (6) risks associated with "Code 3" or emergency driving; and (7) risks at the scene of emergencies including assault and battery. In consideration of City's agreement to provide the Clinical Experience to Student, without cost, Student agrees to release and forever discharge City and its agents, employees affiliates, parent corporation, successors and assigns of and from all claims, demands, suits, injuries or damages of any kind arising in any way out of the participation in this program. Student further agrees to: (I) follow City's policies, procedures and work rules; (ii) follow City's instruction and direction with respect to patient care, safety, personal protection; and, abide by City rules and direction. Student understands that failure to follow the City's direction may result, in City's sole discretion, in his/her expulsion fi.om the Clinical Experience program.