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Documenting the Fairfield University Experience During the COVID-19 Pandemic: Personal Identifying/Health Information Agreement

General Statement

I understand and agree that – despite the recommendations of Fairfield University as provided below - the submitted material may contain sensitive personal information about me, including personal health information, and that this information may be archived and shared in the future with other individuals.

Prohibit and Discourage Sharing of Certain Information

I understand that Fairfield University (and the Fairfield University Archives) strongly discourages the sharing of personal health information protected by law – both of myself and others - in connection with this COVID-19 Archival project.  With respect to others, I specifically agree not to include any personal identifying information concerning any other person (including personal health information) or information that could allow a third party to identify other people, including other students or employees of Fairfield University.

Review, Redaction, and Publication

I further understand that Fairfield University (and the Fairfield University Archives) will review the submitted material prior to any publication, reproduction, sharing, or other dissemination of the submitted material). By submitting this material, I agree that Fairfield University (and the Fairfield University Archives) may redact, modify or remove any personal identifying information or personal health information prior to the submitted material being published, reproduced, shared or otherwise disseminated. I also understand and agree that Fairfield University (and the Fairfield University Archives) may choose not to publish, reproduce, share, disseminate or otherwise use the submitted material.

Specific Permission for the Submitted Material

I give Fairfield University (and the Fairfield University Archives) broad permission to perform the following non-exhaustive activities with the submitted materials (including any sensitive personal information or personal health information): organize according to accepted archival principles; create metadata, finding aids, and full-text search interfaces for the preservation and discovery of the materials; make the materials accessible to researchers and staff; and use the materials in exhibits and displays, both physical and online.

Student's Education Record

I understand and agree that any submitted material may constitute an educational record as defined by the Family Educational Rights and Privacy Act (FERPA) and I hereby provide written consent to Fairfield University (and the Fairfield University Archives) to release the submitted material for the specific purposes stated above.

Release and Hold Harmless

I (on behalf of myself and any third party about whom I provide information) agree to RELEASE and HOLD HARMLESS Fairfield University (on behalf of its trustees, employees, and agents) from any claim, demand, liability, or loss arising from or related to the use, non-use, modification, publication, reproduction, sharing or dissemination of any part of the material I have provided to the Fairfield University Archives for its COVID-19 pandemic project.  

This release does NOT apply to any loss or injury caused: (1) SOLELY by Fairfield University’s NEGLIGENCE, or (2) for Fairfield University’s RECKLESSNESS or INTENTIONAL MISCONDUCT.