MC-AORROL-TRVL (12/04)
PAGE 1 of 2
MARICOPA COUNTY COMMUNITY COLLEGE DISTRICT
2411 West 14
th
St r eet , Tempe, AZ 85281- 6942
TRAVEL ASSUMPTION OF RISK & RELEASE OF LIABILITY
Caution: This is a release of legal rights. Read and understand it before signing.
The Maricopa County Community College District is a public educational institution. References to College
("College") include all of the Colleges within the Maricopa County Community College District ("MCCCD"), its
officers, officials, employees, volunteers, students, agents, and assigns.
I ______________________________, freely choose to participate in the ______________________ (henceforth referred
to as the “Program”). In consideration of my participation in this Program, I agree as follows:
SPECIFIC HAZARDS OF TRAVEL: (Specific dangers endemic in this Program’s area of travel.)
INSTITUTIONAL ARRANGEMENTS: I understand that College is not an agent of, and has no responsibility for,
any third party which may provide any services including food, lodging, travel, or other goods or services
associated with the Program. I understand that College is providing these services only as a convenience to
participants and that accordingly, College accepts no responsibility, in whole or in part, for delays, loss,
damage or injury to persons or property whatsoever, caused to me or others prior to departure, while
traveling or while staying in designated lodging. I further understand that College is not responsible for
matters that are beyond its control. I acknowledge that College reserves the right to cancel the trip without
penalty or to make any modifications to the itinerary and/or academic program as deemed necessary by
College.
INDEPENDENT ACTIVITY: I understand that College is not responsible for any loss or damage I may suffer
when I am traveling independently, or I am otherwise separated or absent from any College activity. In
addition, I understand that any travel that I do independently on my own before or after the College-
sponsored Program is entirely at my own expense and risk.
HEALTH AND SAFETY: I have been advised to consult with a medical doctor with regard to my personal
medical needs. I state that there are no health-related reasons or problems that preclude or restrict my
participation in this Program. I have obtained the required immunizations, if any.
I recognize that College is not obligated to attend to any of my medical or medication needs, and I assume
all risk and responsibility therefore. In case of a medical emergency occurring during my participation in
this Program, I authorize in advance the representative of the College to secure whatever treatment is
necessary, including the administration of an anesthetic and surgery. College may (but is not obligated to)
take any actions it considers to be warranted under the circumstances regarding my health and safety. Such
actions do not create a special relationship between the MCCCD and me. I release the MCCCD, its officers,
officials, employees, volunteers, students, agents and assigns from all liability for any bodily injury or
damage I sustain as a result of any medical care that I receive resulting from my participation in Program, as
well as any medical treatment decision or recommendation made by an employee or agent of the MCCCD. I
agree to pay all expenses relating thereto and release College from any liability for any actions.
