Student Agreement and Release

In consideration of ___________________________ of ___________________________, _______________________ ("SPONSOR") granting permission to WPI students to conduct certain project work at their facility and/or under their sponsorship, I, _________________ ____________________________ of Worcester Polytechnic Institute, Worcester, Massachusetts do hereby agree:

THAT I am familiar with and agree to work within the contractual agreement on projects between SPONSOR and WPI, dated __________________;

THAT such work will be performed by me as a registered student at WPI for academic purposes and not as an employee of SPONSOR for compensation;

THAT reports on the results of my studies will be made available to SPONSOR and WPI;


THAT I have been provided with a copy of the current WPI's Intellectual Property Policy and have read and understood the terms and conditions of the policy;

THAT ownership rights to any inventions, discoveries, know-how or products produced or developed while working on the project shall be governed by WPI's Intellectual Property Policy;

THAT I will abide by the rules and regulations in force and effect at SPONSOR's facility during my presence there;

THAT I hereby release and agree to hold harmless SPONSOR its officers, agents, or servants, from any and all liability for personal injuries to me or damage to or loss of any of my personal property suffered in connection with the performance of said project work unless such injuries, damage, or loss are due solely to negligence on the part of SPONSOR or its employees.

Signed and sealed this ___________ day of ___________________, 20__.

	Name:		___________________________
	Address:	___________________________

	Witness:        ___________________________
	Name:		___________________________
	Address:	Projects & Registrar's Office
			Worcester Polytechnic Institute
			Worcester, MA 01609

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Last modified: August 27, 2007 08:25:24