RANDOLPH COMMUNITY COLLEGE STUDENT RELEASE FORM
FIELD TRIP and ACTIVITIES
IMPORTANT: PLEASE READ
Your signature on this document releases Randolph Community College from legal
responsibilities should an accident or injury occur on, or during, school related or
sponsored field trips or activities. The student assumes full responsibility for
himself/herself and his/her actions.
Students under 18 years of age must have a parent’s signature.
____________________________________________ _________
Printed Name of Student Age
RELEASE
I, the undersigned student or parent (if student is under 18 years of age) hereby release
and forever discharge Randolph Community College and all of the members of said
organization, and all agents, representatives and employees of said organization and their
successors from all claims and demands whatsoever which I, my heirs, executors and
administrators, have or may have against the said organization or its successors or against
said members, agents, representatives or employees, by reason or any injuries arising out
of my student activities, field trips, road trips, or any other activities directly or indirectly
involving the said organization and my consequences resulting directly or indirectly
therefrom.
This the ___________ day of _______________________, 20______.
___________________________ ____________________________
Student’s Signature Parent’s Signature (if applicable)
