Southern Crescent Technical College
Student Activities
Self Transportation Waiver
This form is to be signed by all students who are unable to utilize College transportation to an event and choose to
obtain/provide their own transportation. This form must be completed, signed and turned in to their Faculty/Staff
Advisor prior to departure for the event.
Name of event: _______________________________________________________________
Location(s) of event: ___________________________________________________________
Date(s) of event: ______________________________________________________________
Group attending event: _________________________________________________________
Faculty/Staff Advisor: __________________________________________________________
I, ___________________________________________, am aware Southern Crescent Technical College has made
transportation available to and from the above mentioned event and I have chosen to arrange for other transportation
for the purpose of my participation. I understand that I am responsible for cost and expenses related to my
transportation. I hereby waive and release any and all claims, actions, causes of actions, and demands I may have,
now or in the future, against Southern Crescent Technical College, their agents, employees, representatives,
successors, assigns, or any persons operating by or on behalf of the College for, upon or by reason, of any damage,
loss or injury which may be sustained by me in consequence of my transportation to and from the abovementioned
event. This release extends and applies to all unknown, unforeseen, unanticipated, and unsuspected injuries,
damages, loss and liability and the consequences of them, as well as those disclosed and known to exist. The
provisions of any state, federal, local or territorial law or statute providing in substance that releases shall not extent
to claims, demands, injuries or damages which are unknown or unsuspected to exist at the time, to the person
executing such release, is hereby expressly waived. I hereby agree and understand that the terms hereof shall be
binding upon myself, my heirs, assigns, and personal representatives. All matters hereunder shall be resolved in
accordance with the laws of the state of Georgia notwithstanding the location of the abovementioned event, the route
of travel or the location of my personal residence. The terms hereof shall serve as a release and assumption of risk
by my heirs, estate, executor, administrator, assignees, and all members of my family.
Signature: _______________________________________________________________________________
Print Name: ______________________________________________________________________________
Student ID#:______________________________________________________________________________
(If Under 18) Parent/Guardian Signature: _______________________________________________________
Date: ___________________________________________________________________________________
As set forth in full in the Student Handbook/Course Catalog, Southern Crescent Technical College is an Equal Opportunity
Institution and does not discriminate on the basis of race, color, national origin, sex, age or disability.
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