Idaho State University
Field Trip/Event Informed Consent Form
Every student participating in a college-sponsored trip must read and sign this consent form
prior to the departure of a field trip or the beginning of an event. In addition, students who are
younger than 18 years of age must have the signature of a parent or guardian.
Field Trip/Event:
Scheduled Date(s):
I, the undersigned, have enrolled and intend to participate in the Idaho State University
sponsored field trip/event identified above. I acknowledge that I have read the course/program
outline and voluntarily accept all risks associated with the activities. I agre
e to hold Idaho State
University and all of its officers, agents, and employees free from liability in the event I suffer
personal injury or damage as a result of participating in the field trip/event, due to my
negligence.
I further agree that I am solely responsible for my own equipment, personal property and effects
during the course of the
field trip/eve
nt. I agree t
hat all partie
s
above whom I have h
ereby held
free from liability are only responsible for the general supervision of the logistical/educational
aspects necessary to provide a sage and successful field trip/event and that they cannot and do
not guarantee my personal safety.
I further agree that if I drive my own motor vehicle for transportation to, during or from the
program site, I am responsible for my own acts and for the sa
fety and security of my own
vehicle. I accept full responsibility for the liability of myself and my passengers, and I
understand
that if I am a passenger in such a private vehicle, Idaho State University and its personnel are
not in any way responsible for the safety of such transportation and that Idaho State University
insurance does not cover any damage or injury suffered in the course of traveling in such a
vehicle.
I have notified the supervising ISU instructor/ISU staff member of any existing medical condition
or medication which coul
d affect my
ability to full
y participate
in this f
i
eld trip/event. In the event
that any medical attention is needed, I authorize the leader(s) of the field trip/event or any
qualified individual to administer the first aid necessary to maintain health until a physician may
be reached or other medical assistance obtained. I further authorize any physician to administer
such medical or surgical treatment diagnosed as necessary.
By my signature below, I hereby agree to and fully understand all of the a
bove issues/
c
onditions
and do acce
pt full respo
nsibility as outlined above.
Student Na
me (please print):
Student Signature:
Date:
Parent/Guardian Signature:
Date:
(If participant is younger than 18 years of age)
Name of Emergency Contact:
Phone:
Relationship:
Revised March 2013
Page 1 of 1
Clear Form
Print Form