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Department of Political Science
California State University, Bakersfield
9001 Stockdale Highway Bakersfield, CA
93311 Phone:
661-664-2141 Fax:
661-665-6075 |
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OFF CAMPUS ACADEMIC PROGRAMS
Participant Agreement and Release
This is an
assumption of risk and release of legal rights. Read and understand it before
signing.
#1
VOLUNTARY PARTICIPATION
Participation
in this Off Campus Academic Program is VOLUNTARY. Participation in this program
is not mandatory for completion of degree requirements.
#2
PARTICIPANT RESPONSIBILITIES
All
participants must execute the Participant Agreement and Release and Medical
Disclosure and Waiver of Liability prior to participation in the program.
Each
participant must obtain all necessary passports, visas, and health
certifications for participation in the program. A photocopy of the passport
must be provided to the group leader.
For
international programs, participants must obtain health insurance through the
CSU Study Abroad Health Insurance Program.
The
participant acknowledges and agrees that any logistical arrangements entered
into by him/her to enable participation in the program are the sole
responsibility of the participant. The University is not responsible for
services, payments or guarantees provided pursuant to such arrangements.
#3 CONDUCT
AND DISCIPLINE
Each state or
foreign country has its own laws and standard of acceptable conduct, including
dress, manners, morals, politics, drug use and behavior. Behavior, which
violates laws or standards, could harm the University’s relations with those
states, countries and institutions, as well as the health and safety of
participants. Each participant is responsible for becoming informed of and abiding
by laws and standards for each country to or through which they will travel
during the program.
Participants
are responsible for complying with the University’s rules, standards, and
instructions for behavior. Any violation of standards of conduct could lead to
sanctions being imposed that are consistent with CSU Student Discipline
Policies and Procedures, including, but not limited to suspension or expulsion
for the program.
Participants
are personally responsible for attending to any legal problems they encounter
including those with foreign nationals or governments. The University is not
responsible for providing any assistance under such circumstances.
#4 ACADEMIC
PROGRAM
This trip
provides individuals with an opportunity to visit Vietnam and Cambodia. Each
city selected for the tour combines historical, natural, cultural and political
activities so everyone will find something of personal interests at each
stop.
#5 SUPPORT
PROGRAM
Transportation
will be provided from Bakersfield, CA to Vietnam/Cambodia and back to
Bakersfield.
#6 SERVICES
NOT PROVIDED
The University
is not furnishing, is not responsible for and assumes no liability in
connection with matters other than academic instruction and the logistical
services listed above. The University is not furnishing, is not responsible for
and makes no guarantee of safety of participants or elimination of all risks
from the environment. The University is not responsible for and assumes no
liability for monitoring or control of the daily personal decisions, choices
and activities of the individual participants. The University is not responsible
for and assumes no liability for: the safety of personal property; prevention
of participants from engaging in illegal, dangerous or unwise activities; the
actions of persons not employed or otherwise engaged by the University; events
that are not part of the program or that are beyond the control of the
University; or assurances that home-country culture values and norms will apply
in the host country.
#7
UNIVERSITY FEES
University
fees will only be necessary if the participant chooses to receive course
credit.
#8
ADDITIONAL STUDENT FEES
There are no
additional fees.
#9 TOTAL
FEES
The
#10 PROGRAM
CHANGES
Program fees
are based on current airfares, lodging rates, and travel costs which are
subject to change. The University has the right to make cancellations,
substitutions or changes in case of emergency, changed conditions or as needed
in the best interest of the program. Participants accept responsibility for
loss or additional expenses caused by delays, changes in the means of transportation
or other services, sickness, weather, strikes, or other unforeseen causes.
#11 REFUNDS
Define the
policy that will be applied to withdrawal / expulsion from or cancellation of
the program.
#12
INDEPENDENT ACTIVITY AND TRAVEL
The University
is not responsible for any injury or loss participants may suffer when acting
or traveling independently or if otherwise separated or absent from any
University supervised activities. This includes but is not/limited to free time
during the program.
If a
participant becomes detached from the group, fails to meet a transport
departure or becomes sick or injured, they are responsible for contacting and
rejoining the program group at their own expense.
#13
ASSUMPTION OF RISK
Participation in this program involves risk not found in study at the University. Risks may include: traveling to, from and within one or more foreign countries; variability of foreign political, legal, social and economic conditions; different standards of design, safety and maintenance of buildings, public places and conveyances; different standards for sanitation, and variability of weather conditions. Other risks include: illness, bodily injury, death, property loss or damage, kidnap, extortion, and incarceration.
Participation
in this program requires air travel. Air travel involves risks and could result
in damage to property, injury to persons and death. The California State
University assumes no liability for damage, injury, and death, which may occur
during air travel required by participation in this program.
#14 RELEASE
OF CLAIMS
The University
does not represent or act as an agent for and cannot control the acts or
omissions of the host institution, host family, transportation carrier, hotel,
tour organizer or other provider of goods or services involved in the program.
The University is not responsible for matters that are beyond its control.
Knowing the
risks described in this agreement, and in consideration of being permitted to
participate in this voluntary program, I agree, on behalf of my family, heirs,
and personal representatives, to assume all the risks and responsibilities
surrounding my participation in the program.
I hereby waive
all claims or causes of action against the State of California, the Trustees of
the California State University, California State University Bakersfield, its
auxiliary organizations, and the officers, directors, employees and agents of
all of them arising out of my participation in this activity collectively
referred to as “the State”. I hereby release, hold harmless and discharge the
State from all liability in connection therewith.
#15 SOLE
AGREEMENT
This
Participant Agreement and Release and the Medical Disclosure and Waiver contain
the sole and entire agreement between the University and participant and shall
supersede any and all other agreements between the parties.
I read this
Participant Agreement and Release Form before signing it. No other representations,
statements, or inducements, oral or written, have been made. I acknowledge that
I have received a complete copy of this agreement.
_____________________________ ______________________
Signature of participant Date
_____________________________ _____________________________
Printed name Name
of Emergency Contact
Address _____________________ Address _____________________
____________________________
_____________________________
Phone Number __________________ Phone Number ______________
I am the parent or legal guardian of the participant and have
read the Participant Agreement and Release including portions that may subject
me to personal financial responsibility. I will be legally responsible for the
obligations and acts of the participant as described in this Participant
Agreement and Release and agree, for myself and for the participant, to be
bound by its terms. I acknowledge that I have received a complete copy of this
agreement.
_________________________________ ___________________
Signature of parent or guardian Date
if participant is less than 18
Years old
_______________________________
Printed name
Address ________________________
________________________ Phone Number _____________