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TRAVEL and TRIP RISK ACKNOWLEDGEMENT/LIABILITY WAIVER FORM
International Service Learning Tours
Partnering People Through Service provides service learning trips for high school and college students. Participants and leaders are expected to conduct themselves in a professional and positive manner as representatives of P.P.S. All students must adhere to and are responsible for following the student code of conduct for their respected schools. Failure to follow P.P.S. policies may result in disciplinary action. (Policies can be found on our website partneringpeoplethroughservice.org).
This is to certify that _______________________________________ has full permission to, and/or has voluntarily agreed to: (Student / Participant Name – Print)
Participate in a service learning trip sponsored by Partnering People Through Service.
- LIABILITY WAIVER / RISK ACKNOWLEDGEMENT:
I understand that participation in trip activities could involve risk of physical injury, illness, death or property loss, and despite safety precautions, P.P.S. cannot guarantee safety thereof, as all risks cannot be prevented. , and I understand that any medical expenses, property loss, or other personal expenditures that result during or from this travel/trip, are to be borne by the student/participant, or by their parent or guardian (if student/participant is a minor). I also hereby consent, give authorization to, and release from liability; trip leaders to secure any emergency medical treatment in event I am unable to, and I agree to be responsible for the costs thereof.
I also understand that the P.P.S. cannot be responsible for assuring the safety and reliability of such private transportation or driver, nor for any non-sponsored activities and travel that I/my child might choose to participate in before, during or after the P.P.S. sponsored function, and I therefore accept the risks and responsibilities associated with such private vehicle travel and activities.
In consideration of the opportunity afforded, with full knowledge and acceptance of the risks associated with this trip and any recreational activities noted within; and with full understanding of the above issues/conditions and risks, I hereby release, indemnify and hold harmless Partnering People Through Service, its staff, trustees, officers, volunteers, and agents from all form and manner of risks inherent in, and from all claims, suits and demands of any nature arising from participation in said trip, or activities.
__________________________________________________________ __________ ________________________________________________________________
Signature of Student/Participant Date Signature of Parent or Guardian Date
(needed if student/participant is a minor – under 18 )
Print Student/Participant Name Print Parent/Guardian Name
Signature of Witness for Student/Participant Signature of Witness for Parent/Guardian
Emergency Contact Name:________________________________________ Phone:________________________________