CCS 40-228 (Rev. 06/18)
Marketing and Public Relations
Global Education International Programs
STUDY ABROAD - Travel Waiver
(Independent Departure)
Travel Waiver, Release, and Indemnification Agreement (Independent Departure)
This is to inform you that I am departing independently for the Community Colleges of
Spokane Study Abroad Program (Program”) as o
f
(date),
have made other travel arrangements, and will not continue with the Program, including
its study or travel itinerary, as planned. I will be staying in the following location(s) after I
leave the Program:
:
I plan to return to the United States on the following date
1) I agree and hereby acknowledge that once I leave the Program, the Community
Colleges of Spokane (“CCS”), its officers, agents, employees, and departments and the
host institutions abroad are no longer responsible for me in any manner and that the
Program and activities surrounding it have then ended with respect to my participation
therein.
2) In consideration of being allowed to depart independently from the Program and any
related activities, I do hereby, individually, and on behalf of my heirs, successors, personal
representatives, and assigns, release and forever discharge CCS, its officers, agents,
employees, and departments and the host institutions abroad (in their official and
individual capacities) from any and all liability whatsoever for any injury, loss, damage,
accident, delay, or expense which arise out of or result from my independent departure
from the Program and related activities, or which occur during the period when I otherwise
would have been participating in the Program and/or related activities if I had not decided
to depart independently, including, without limitation, any travel incident thereto.
3) I agree that this Waiver, Release, and Indemnification Agreement (“Waiver and
Release”) is to be construed under the laws of the State of Washington, that it is intended
to be as broad and inclusive as permitted by the laws of the State of Washington, and that
if any portion hereof is held invalid, the balance hereof shall, notwithstanding, continue in
full legal force and effect.
4) I certify I have read and understand, and am competent to sign this document. I hereby
voluntarily sign this document, agree to follow the rules and requirements described
above, knowingly assume the above described risks and responsibilities associated with
the trip/activity, and agree to accept full personal and financial responsibility for my actions
during this trip and/or activity.
5) I have informed the Program staff of my plans and travel itinerary for the period after I
separate from the Program or its activities in order to assist them in reaching me in an
emergency.
Signature
Date