Program Leader Handbook - International Education and ...

Appalachian Overseas Education Programs Program Leader Handbook
Appendix K ‐ Assumpon of Risk Indemnificaon Agreement ‐ Extended Stay
ASSUMPTION OF RISK INDEMNIFICATION AGREEMENT
(Extended Stay)
Appalachian State University (“ASU”) makes study abroad programs available to students. During the period
_______________________________________, one such Program has been held in __________________________________. I
understand that ASU does not and could not ensure that students’ parcipaon in the study abroad program is free from risk. On
the contrary, in light of events on and aer September 11, 2001, no one can provide assurance with respect to either the safety
of persons traveling anywhere in the world or the financial stability or viability of airlines and other businesses in the travel industry.
I have been accepted as a parcipant in the ______________________ Study Abroad Program, and although I have been
strongly advised that it would be potenally very dangerous for me to travel in ___________________________________on my
own, I wish to remain in________________________________ aer the program concludes and all other ASU‐related personnel
have le the _________________________________________.
I have been advised and I understand that the potenal risks involved in remaining in the ___________aer the conclusion of the
Program include risks of personal injury and death, incarceraon, and/or property damage or loss. I will and hereby do assume
sole and full responsibility for my liberty, safety, and property if I remain in the ________________________________________. I
also understand that the Program and all responsibilies of ASU and of the program leader, will end on
________________________, when the ASU program leaders will accompany program parcipates to the
______________________ airport, where the program parcipates and program leaders will begin the return to Charloe, North
Carolina. In consideraon of being permied to remain in the ______________________________ aer the conclusion of the ASU
____________________________________ Summer 20___Study Abroad Program,
I agree as follows:
1. I understand the possible risks and dangers to me and my property associated with my remaining in the
________________________________, and I do so voluntarily in reliance upon my own judgment and ability. I assume
all risk of personal injury, death, incarceraon, and property damage of loss from any cause whatsoever, including,
but not limited to, my own conduct, the failure of anyone to enforce laws, rules and regulaons or to inspect
equipment or facilies, and the negligence of anyone else;
2. I understand that during the period of the Study Abroad Program, program parcipants are covered by a travel insurance
policy that includes health and accident and repatriaon coverage, and that this coverage may be extended at
my own expense up to 7 days aer the conclusion of the ASU ___________________Study Abroad Program; and
3. I release and shall indemnify, defend and save harmless Appalachian State University, The University of North Carolina,
the State of North Carolina and their respecve officers, agents and employees from all liabilies, losses, costs,
damages, claims or causes of acon of any kind or nature whatsoever, and expenses, including aorneys fee, arising
or claimed to have arisen out of personal injuries or death, or property damage or loss, sustained by me as a result of
any cause whatsoever including but not limited to my own conduct, negligence or other misconduct on the part of
Appalachian State University officers, agents, or employees, or those injuries or property damage sustained by others
as a result of my own negligence or intenonal acts, during my joining and traveling with the Program group
(including travel to and from and within the host country).
I cerfy that I am at least eighteen (18) of age, medically and mentally sound, physically fit to engage in the acvies described
above, and competent to enter into this agreement. I further cerfy that no oral promise, agreement, warranty or representaon
concerning safety or liability has been made to me.
I HAVE READ AND UNDERSTAND THIS ASSUMPTION OF RISK AND INDEMNIFICATION AGREEMENT, I UNDERSTAND AND AGREE
THAT IT WILL LEGALLY BIND ME AND MY ESTATE, AND I SIGN IT VOLUNTARILY.
60
__________________________
Student Signature
_______________________
Date
If parent or guardian: __________________________ _______________________
Parent or Guardian Signature
Relaonship to Parcipant
Revision Date 5/8/13
507_AOEP_LeaderHandbook