Anne Arundel Community College
Student Travel Agreement
Club: __________________________________ Event/Activity: __________________________________
Event /Activity Dates: ____________ to ___________ Off Campus Location: _______________________
Student Name: _______________ _____ _______________________ Student ID _______________
First Init Last
Home
Address: ______________________________________________ E-mail: _____________________
Street
___________________________________ _________ Cell Phone: ____-____- ______
City, State Zip
Responsible College employee accompanying students _______________________ Cell ____-____-_____
I _________________________________ understand that I am representing Anne Arundel Community College,
and agree to conduct myself in a proper and courteous manner at all times and to adhere to the Student Conduct
Code contained in the College Catalog.
I hereby confirm that I agree to attend this conference/activity and understand that the college has made a
considerable financial investment. I understand that if I should cancel, and a replacement is not found, I will be
responsible for reimbursing the college all expenses incurred on my behalf.
I understand and agree that Anne Arundel Community College, its Board of Trustees, faculty, staff, agents and/or
employees are not responsible for any injury, damage or loss incurred by the undersigned while traveling and/or
participating in conferences/activities. I understand that I am solely responsible for my actions/inactions, at all
times, while participating in conferences/activities to include, but not limited to, travel to and from the destination,
during my participation in the activity and during any free and unsupervised time.
I hereby agree to and shall save and hold harmless Anne Arundel Community College, its Board of Trustees,
faculty, staff, agents and employees, from any claims, actions, or judgments arising from my actions or inactions
during my participation in conferences/activities.
I ____________________________ hereby affirm that I have read this authorization to participate in travel
and the Student Conduct Code prior to execution of this Authorization and I accept all responsibilities
contained herein.
_______________________________________ _____________________________________ ___________
Student Signature Date Parent/Guardian Signature (if student under 18) Date
Emergency Contacts (provide two, please print):
_______________________________________ ___________ ___________ _______________
Name Relationship Day Phone Evening Phone
_______________________________________ ___________ ___________ _______________
Name Relationship Day Phone Evening Phone
RM Std Clb travel form
