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Agreement and Release Note: This document is also available in printer-friendly .pdf format here. This is a release-read this carefully The undersigned, being a student at Monmouth College, and applying for participation in the ___________________________________ program, and having the opportunity to gain certain academic credit through participation in such program, and in consideration of one dollar ($1.00) and other good and valuable consideration receipt of which, a one portion of the program fee, is hereby acknowledged; hereby agrees and forever releases Monmouth College and each of them and any officer, director, staff, employee, servant, representative, trustee, insurers, heirs, executers, administrators, successors and assigns, and or agent thereof of and from any and all liability for any act or omission of any kind or character whatsoever and releases them from any and all costs, damages and claims or assertions of any kind which the undersigned or any of my heirs, successors or assigns may at any time claim or otherwise assert against them and specifically without limitation agree as follows: 1. The program director has the unlimited authority to establish rules concerning the operation of the program and should the director decide that a student be separated from the program because of any violation of such rules, for behavior deemed disruptive to the program, or for any conduct which could adversely impact the program that such a decision will be final and unappealable; 2. Program tuition covers educational costs of the program, such as staff salaries. Because these costs are fixed, once participation in the program has started, tuition refunds will be strictly limited, and will be made in accordance with the policy on the home campus. Such participation shall be defined as either the day the students arrive on the program site or begin group travel; 3. The undersigned hereby releases Monmouth College, any member of the college, any officer, director, staff, employee, servant, representative, trustee, insurers, heirs, executers, administrators, successors and assigns, and or agent, thereof, from any and all personal injury to myself or any damage to, or loss of any personal property caused by acts or omissions of anyone, including but not limited to hotels, carriers, fellow students, restaurants, educational organizations, persons, groups or organizations, including but not limited to Monmouth College, relating to or arising out of the work or study in the ____________________________ program. I have read the foregoing Agreement and Release, fully understand it and accept the conditions stated therein. ___________________________ ___________________________ Agreement and Release With Indemnification Agreement This is a release-read this carefully The undersigned, being the parent or guardian or other legal representative of________________(the student), a student at Monmouth College, who has sought and received my permission to participate in the _______________________ program, which I understand will necessitate the travel of my student from__________________ to ________________ to participate in such program, hereby agrees and releases and forever discharges the College and all their officers, directors, staff, employees, servants, representatives, trustees, insurers, heirs, executers, administrators, successors and assigns, and or agents of and from any and all liability of any kind or character whatsoever to me or my heirs, successors or assigns with respect to any act or omission by Monmouth College to the participation of the Student in the Program. I further agree that I will indemnify, defend and hold harmless Monmouth College, their officers, directors, staff, employees, servants, representatives, trustees, insurers, heirs, executers, administrators, successors and assigns, and or agents from any and all claims of any nature whatsoever made by anyone which in any way arise out of or in any way related to any activity of the student participation in the program. I have read and understand the terms and conditions of this Agreement, Indemnification and Release and I agree and subscribe to them. My signature below also signifies that the student has sufficient health, accident, disability and hospitalization insurance to cover him/her during participation in the program, that Monmouth College is named an additional insured thereunder, and that I expect and recognize that none of the fee paid for this program goes toward the payment of such insurance, and that Monmouth College has no obligation to provide insurance related to the student. I further state that I have read the terms of the Agreement and Release attached hereto, that has been signed by the student with my permission, and that I understand fully said agreement and agree to be bound by the same terms and conditions as if I myself had signed the Release and Agreement. ________________________________ ___________________________
This webpage was prepared by Professor
Thomas J. Sienkewicz of Monmouth College.
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