ESCP Europe – Student Immersion Program REGISTRATION FORM Form is successfully submitted. Thank you! First Name*Last Name*Company Name*Job Title*Email*PhoneFood preferenceNo preferenceVegetarianHalalKosherCommentsI understand that, although Silicon Valley Innovation Center has made every reasonable effort to assure my safety while participating in the program, there are unavoidable risks associated with any program, activity, or field trip including the following specific risks: travel to, from and during the program or activity, risk of personal injury as the result of participation in physical activities such as walking, etc. I do hereby acknowledge that I am fully aware of all risks and hazards that may be directly or inherently involved in this program or activity. With full knowledge of the facts and circumstances surrounding this activity, I do hereby assume all responsibility and risk from my participation in this activity, including all risk of property damage, injury, and other hazards to me. I hereby release and promise not to sue Silicon Valley Innovation Center or its employees and agents, for any damages or injury (including death) caused by, derived from, or associated with my participation in the program.*I agree SUBMIT
