Student Seeking PPW Host Question Title * 1. Please write your full name: Question Title * 2. Please provide your email address Question Title * 3. From where are you traveling? Question Title * 4. What nights do you need housing for PPW 2014? March 29 March 30 March 31 April 1 Question Title * 5. Do you have any pet allergies? Yes No Question Title * 6. Please provide any additional information in the box below: Question Title * 7. Release: Participant agrees to release, indemnify, hold harmless and defend the Academy and its members, trustees, directors, officers, employees, contractors, agents, affiliates, and successors and assigns (collectively “Releasees”) from and against any claim which Participant, his/her legal guardian(s), or any other person, may have for any losses, damages, or injuries arising out of or in connection with Participant's participation in the housing accomodations. The Academy shall also not be responsible to Participant, Guardian, and/or any other person for illness, injury or damage to or loss of property due to Participant's own acts or omissions. I agree Done