Revised August 2014
Waiver of Liability for Local and Out-Of-State Travel
Class/ Club: ___________________________________________________
Description of Event____________________________________________
Instructor/Advisor______________________________________________
Field Trip/Activity Date: __________________________________________
I acknowledge that there are certain risks inherent in my participation in field trips or off-
campus activities. I voluntarily assume all risk of injury to myself or damage my property
and agree to hold harmless Orange County Community College, its directors, officers,
employees and authorized agents from any and all liability, claims, or causes of action
arising out of my transportation to and from and my participation in this field trip or off-
campus activity. If I choose to transport other persons or students in my personal
vehicle to this activity, I certify that I have adequate insurance and I agree that I shall
indemnify Orange County Community College against any claim brought against them
by my passengers.
I will follow the Orange County Community College Student Code of Conduct while
participating in this activity. I will not possess or use alcohol or unlawful substances while
I am participating in this activity.
I have carefully read this agreement and fully understand its contents. I'm aware that
signing this agreement constitutes a release of liability and I sign of my own free will.
Participant/Student (Print Name) Date
Participant/Student (Signature)
Signature of Parent or Legal Guardian Date
(If student is a minor)
Emergency Contact Information
Name: Relationship:
Address: Telephone #:
