________________________________ _________ ____________________________
FIELD TRIP STUDENT RELEASE FORM
Club or Program Name:
Release, Waiver of Liability, and Covenant Not to Sue
(Read Carefully Before Signing)
The undersigned hereby acknowledges that participation in field trip activities involves inherent risk of physical
injury, illness, or loss of personal property and assumes all such risks. The undersigned hereby agrees that for the
sole consideration of
Southern Crescent Technical College allowing the undersigned to participate in field trip
activities which, for which, or in connection with which, the college has sponsored or made available any equipment,
facilities, grounds, or personnel for such program or activities or to the undersigned does hereby release and forever
Southern Crescent Technical College and the Technical College System of Georgia, its members
individually, and its officers, agents, and employees from any and all claims, demands, rights and causes of action
whatsoever kind or nature, arising from and by reason of any and all known and unknown, foreseen and property,
and the consequences thereof, resulting from my participation in, or growing out, or connected with, such field trip
I understand that the acceptance of this Release, Waiver of Liability, and Covenant Not to Sue by the Technical
College System of Georgia shall not constitute a waiver, in whole or in part, of sovereign immunity by said Board, its
members, officers, agents, and employees.
I hereby certify that I am _______ years of age and that I have read the above carefully before signing.
In Witness Whereof, I have hereunto set my hand this _________ day of _____________________, 20_ . ______
Field Trip Participant Witness
Code of Conduct
I hereby agree that in consideration of my being permitted to participate in this Southern Crescent Technical
College field trip as a student. I will be subject to the supervision and authority of the faculty and/or Director in
charge. I also understand and agree that the faculty and/or Director in charge has the sole authority to make
decisions regarding my continued participation in the field trip program if they determine that my conduct
warrants disciplinary action of if they determine that my continued participation, for whatever reason, poses an
immediate risk of harm to me or others.
Assumption of Risk, Waiver of Liability, and Medical Authorization
I recognize that participation in this field trip program entails certain risks to my property and person that, in rare
circumstances, can be serious or even lethal. In particular, I understand that this
Southern Crescent Technical College
trip will involve the following activities:
• Riding in a state provided vehicle, driven by a state employee, to and from the college campus to the
destination and related locations.
• Staying overnight at a hotel.
• Participating in competitions, workshops, and team building activities.
• Other related activities
I freely assume those risks associated with these activities. I further understand and agree that
Technical College shall not assume any liability for damage to or loss of my property or for financial obligations
incurred by me. I also agree to give up any rights I may otherwise have to sue or otherwise bring claims against
Southern Crescent Technical College and its officers, faculty, employees or agents, for personal injuries or death or
other harm, except for those injuries, death or other harm caused by deliberate wrongful act of the aforementioned
Technical College/and or its officers, faculty, employees or agents. I understand that it is possible for me to
purchase insurance, at my own expense, that will indemnify me against the risk of the financial losses outlined in
In the event of an emergency and I am unable to act on my own behalf, I authorize the faculty and directors of the
field trip to take whatever action they deem is warranted and appropriate regarding my health and safety.
Approval and Student Acknowledgment
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