Travel Acknowledgement of Risk and Waiver of Liability Forms

When participants in an activity sign waivers, they are voluntarily relinquishing their privileges to which they are legally entitled. Waivers are also
referred to as “exculpatory agreements” because the participants are exculpating, or forgiving in advance, any future negligent conduct (NRPA, 1996).

It is important for USF departments, organizations and clubs to utilize waivers to both protect the University from unnecessary liability and to inform
students of the known risks associated with the event in which they are participating. However, it is also important to recognize what a waiver does not
do. For example, waivers do not excuse failure to train, failure to check equipment, failure to supervise and failure to take reasonable precautions. A
participant cannot waive or release his or her right to any claim “based upon the willful or wanton misconduct of the provider” (NRPA, 1996).

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Event Title [Required]
What are you attending?

Where are you traveling to? [Required]

Please list the location you are going to.

When do you leave? [Required]

When do you come back? [Required]

Are you 18 years or older? [Required]

[ ] Yes
[ ] No

Will you be driving? [Required]

There is an additional waiver form for those who are driving to their destinations.

[ ] Yes
[ ] No

Please list a Contact in case of an Emergency. [Required]

Phone Number of Emergency Contact. [Required]

Valid input:
- must be 10-15 digits long and may include only numbers, hyphens, and spaces.

Travel Acknowledgement of Risk and Waiver of Liability

Travel Acknowledgement of Risk and Waiver of Liability [Required]
In consideration of being permitted to travel to and participate in any way in the event listed above, I do hereby release, waive and discharge the State of Florida, University
of South Florida Board of Trustees, their representatives, its officers, employees, agents, advisors, employees, and members, and the event sponsor, USFSM, and its
advisor(s), officers, and members from any and all actions, damages, claims or demands which I, my heirs, personal representatives, executors, administrators or assigns
may have against any and all of the aforementioned for any and all personal injuries, accidents or illnesses (including death), known or unknown, which I have or may incur
by participation in the above stated event and for all damages and loss to my property.

I understand that my traveling for and participation in this event is voluntary and that this event carries with it certain dangers and risks, including but not limited to:
overexertion, poor judgment, emotional strain, slipping, falling, equipment failure, up to and including injury and death which could ultimately result in injury, permanent
disability, or death. I realize that I am responsible for any injuries to persons or property which may be incurred in connection with my participation in this event.

I also agree to indemnify and hold harmless the State of Florida, University of South Florida Board of Trustees, their representatives, its officers, employees, agents,
advisors, employees, and members, and the event sponsor, USFSM, and its advisor(s), officers, and members of the aforementioned from any and all costs, damages,
liabilities and losses that they may incur due to my participation in this event. I hereby agree to abide by any policies, rules and regulations adopted by the aforementioned.

I further expressly agree that the foregoing acknowledgement of risk and waiver of liability is intended to be as broad and inclusive as is permitted by the law of the State of
Florida and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I, the undersigned, am at least 18 years of age. I have read this Travel Acknowledgement of Risk and Waiver of Liability and fully understand its terms. I acknowledge that I
am signing this waiver freely and voluntarily with full knowledge of its significance. If the participant is younger than 18 years of age, then his/her parent or legal guardian
must also sign where indicated.
Valid input:
- Select only one choice.

[ ] I Agree

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 Please Type Your Full Name [Required]

Please Enter Your Full U# [Required]

Please Enter Your Birthdate [Required]

*Please remember to change the birth year to the correct year*

File Upload
You can upload a copy of your medical insurance in case of an emergency here.

File Upload

Under 18
I am the parent or legal guardian of the participant indicated here, who is under the age of 18. I agree on behalf of my child or ward to all the terms
contained in this release.

Enter Reviewer Email [Required]

Please enter an email address of a parent or legal guardian. An email will be sent to them for their approval. If there are any questions, please contact Christine Uphoff at
cmuphoff@usf.edu.
Valid input:
- name@myschool.edu

Driving Waiver
DRIVER ACKNOWLEDGEMENT OF RISK AND WAIVER OF LIABILITY [Required]
In consideration of being permitted to drive to, at, and from the listed location to participate in the listed event. I do hereby release, waive and discharge the State of Florida,
University of South Florida Board of Trustees, their representatives, its officers, employees, agents, advisors, employees, and members, and the event sponsor, USFSM,
and its advisor(s), officers, and members from any and all actions, damages, claims or demands which I, my heirs, personal representatives, executors, administrators or
assigns may have against any and all of the aforementioned for any and all personal injuries, accidents or illnesses (including death), known or unknown, which I have or
may incur by participation in the above stated event and for all damages and loss to my property.

I understand that my driving for participation in this event is voluntary and that this event carries with it certain dangers and risks, including but not limited to: overexertion,
poor judgment, emotional strain, slipping, falling, equipment failure, up to and including injury and death which could ultimately result in injury, permanent disability, or
death. I further assume all responsibility related to complying with all applicable motor vehicle laws, including but not limited to: those concerning vehicle safety, vehicle
operation, insurance, and the transportation and consumption of alcohol beverages. I realize that I am responsible for any injuries to persons or property which may be
incurred in connection with driving for participation in this event.

I also agree to indemnify and hold harmless the State of Florida, University of South Florida Board of Trustees, their representatives, its officers, employees, agents,
advisors, employees, and members, and the event sponsor, USFSM, and its advisor(s), officers, and members of the aforementioned from any and all costs, damages,
liabilities and losses that they may incur due to my driving for travel and participation in this event. I hereby agree to abide by any policies, rules and regulations adopted by
the aforementioned.

I further expressly agree that the foregoing acknowledgement of risk and waiver of liability is intended to be as broad and inclusive as is permitted by the law of the State of
Florida and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I, the undersigned, am at least 18 years of age. I have read this Driver Acknowledgement of Risk and Waiver of Liability and fully understand its terms. I acknowledge that I
am signing this waiver freely and voluntarily with full knowledge of its significance.
Valid input:
- Select only one choice.

[ ] I Agree

Please Type Your Full Name [Required]

Please Enter Your Full U# [Required]

File Upload [Required]

Please upload a copy of your Driver's license and a copy of your car insurance.

Additional File Upload

Page 2 of 3 · Travel Acknowledgement of Risk and Waiver of Liability Forms

 Additional File Upload

Travel Responsibility
Student Responsibility for Travel/Events [Required]
This agreement is executed by the traveling student (herein the “attendee”).

1. The attendee shall attend and be present at scheduled conference workshops and events.

2. The attendee shall at all times conform to the rules/regulations set forth by the University of South Florida System (“USF”), Code of Conduct, and specifically, but not
limited to, the USF policy on alcohol usage. These rules and regulations shall apply at all times; as though the student was on USF property. Any event sanctioned by the
USF System or supported by Activity & Service Fees (“A&S Fees”) will be considered to be an USF event.

3. The attendee being sponsored by A&S Fees must be a currently registered USF student in good academic standing. Furthermore, the attendee has met with his or her
instructors and understands that the conference is not an excused absence from class or from any class assignment or participation requirement.

4. Represent the University of South Florida Sarasota‐Manatee, Student Government, and your club/organization with pride, enthusiasm, professionalism and integrity. It is
imperative that students refrain from any activity that is considered hazing or harassment as defined by the State of Florida and/or the Student Code of conduct, and to only
engage in positive group activities that do not single out select individuals or groups based upon their level of membership.

5. Respect all hotel property, personal property and private property. Attendee will not destroy,
damage, or misuse said property.

6. The attendee is aware that there will be no co‐habitation on the University sponsored trip and no consumption of alcohol while traveling to the conference, when at the
conference, or returning from the conference.

7. If the attendee forfeits his or her travel for any reason, the attendee must reimburse the University for the expended dollars. This can include, but is not limited to, hotel
charges, conference registration fees, and the cost of airline tickets.

This document certifies that I, representing my organization, accept responsibility and will be held accountable for my portion of expenses paid from Activities and Services
Fees by Student Government on my behalf for participation in the event that I am unable to attend for any reason. I understand that most payments are non‐ refundable due
to the nature of booking for groups and that charges may include, but are not limited to: hotel, registration, airfare/travel costs, food, and activities.

I agree to repay University of South Florida Sarasota‐Manatee Student Government for my portion of expenses incurred as a result not attending the aforementioned event,
regardless of the reason. Furthermore, I acknowledge that failure to reimburse Student Government for these expenses will result in a “hold” being placed on my account
(until the funds are paid) and that continual non‐compliance of the travel policy may cause me to lose the privilege to travel in the future with any student organization.

By agreeing to this form, I agree to all of the above statements and fully understand that my failure to abide by these regulations may result in the following consequences:

• A formal disciplinary meeting with the Director of Student Life, Advisor, and a student representative.
•Referral to Student Rights and Responsibilities and formal charges for violation of the Student Code of Conduct. This process may result in official University sanctions.
• Removal from your organization.
• Prohibited from future sponsorship for travel for a period of twelve (12) months.
• Referrals to other Student Services as needed.
Valid input:
- Select only one choice.

[ ] I Agree

Please Type Your Full Name [Required]

Please Enter Your Full U# [Required]

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