Waiver Release South Carolina by pcv49840

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									STATE OF SOUTH CAROLINA)                            FIELD TRIP WAIVER AND RELEASE
COUNTY OF RICHLAND)

PROGRAM : _____________________________________ DATE(S): ___________________

PARTICIPATING STUDENT:____________________________________________________
                                              Full Name
DESCRIPTION OF FIELD TRIP: _________________________________________________

___________________________________________________________________________

LOCATION: ___________________________________ DATE(s):_______________________

WHEREAS, I acknowledge that my Child’s participating in is solely on my own initiative, risk and
responsibility;

AND WHEREAS, I acknowledge that I agree that I will abide by and take responsibility for my
child abiding by the rules and regulations as are announced or distributed;

NOW therefore, for and in consideration of my child’s being allowed to ride in the vehicle rented
through ________________________, in conjunction with my and my child’s participation in the
USC PROGRAM _____________________________________________________________,

I, on behalf of my child, our family members, my estate, my child’s estate, our administrators,
executors, agents, heirs, agents, and assigns, do hereby consent as follows:
• I accept and appreciate that there are certain risks and dangers involved in such activities;
• I voluntarily release, discharge, waive, relinquish, indemnify and forever hold harmless and
    covenant not to sue the University of South Carolina, its officers, trustees, agents, assigns,
    and employees, from any and all lawsuits, actions or causes of actions, claims in law or
    equity, demands, liabilities, costs, expenses, property damage, personal injury, or death,
    including attorney’s fees, which result from or may arise out of participation in connection
    with the Field Trip in the USC PROGRAM __________________________, whether
    occurring inside, on, outside, or off of the University of South Carolina.
• I acknowledge and understand that the University of South Carolina does not provide life
    insurance, automobile insurance other than what the vehicle rental agency provides, or
    medical coverage/benefits.
• I understand and agree to pay for the costs of any personal coverage.
• I HAVE CAREFULLY READ AND VOLUNTARILY CONSENT TO THIS FIELD TRIP
    RELEASE AND WAIVER.
• I UNDERSTAND IT TO BE A RELEASE OF ALL CLAIMS AND CAUSES OF ACTION
    FOR MY CHILD’S INJURY OR DEATH OR PROPERTY DAMAGE THAT OCCURS
    WHILE PARTICIPATING IN THE FIELD TRIP.

I warrant I am the parent or authorized legal Guardian of the Participant and I warrant I am 18
years of age or older.

__________________________________________                         Date: ______________ 200_
Signature of Parent or Authorized Legal Guardian

Witnesses:_____________________________             ___________________________________
Updated 5/2001

								
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