FIELD TRIP WAIVER AND RELEASE

     
Prefix Course Title Date (s)
 
Location of Field Trip
   
Instructor Division Director/Dean

I hereby affirm that I plan to participate in the program designated above and that I waive and release all claims against the State Board for Community Colleges and Occupational Education and the Community College of Aurora, their agents and employees, for any injury, damage, claim, delay or expense incurred by me during the course of the field trip. Also, I release the State Board for Community Colleges and Occupational Education and the Community College of Aurora and their agents and employees from any liability for any damage or injury to the person or property of others that I may cause while on this field trip.

I understand that all automobile liability insurance exposures are my own responsibility.

I understand and affirm that my status on this field trip is that of a student.

Student Signature Date Student Signature  Date
1   17  
2   18  
3   19  
4   20  
5   21  
6   22  
7   23  
8   24  
9   25  
10   26  
11   27  
12   28  
13   29  
14   30  
15   31  
16   32