Off-Campus Trip Contact

Please complete the form below before boarding the bus for an off-campus trip.

Release of Liability Statement

The Student Organization/University Office/Department stated below and its officers shall not be liable for any injury, damage, loss, accident, delay or other irregularity which may be occasioned by any company or person engaged in conveying the passengers or carrying out the arrangements of the trips.

Baggage(if applicable) is “owner’s risk” throughout.

I understand and confirm that I am volunteering to attend this trip and that I am not required by Worcester State University as part of my academic requirements.

I understand that I am responsible for meeting at the designated departure time(s) and location(s). Failure to do so will result in forfeiture of the cost of the trip. Further,I understand that individuals who miss the designated return time are responsible for finding their own alternative transportation.

I have read the above conditions and the cancellation policy for the trip in its entirety. I understand the implications and agree to them. 

I also understand that by signing this release of claims form that I am not signing away my rights as an individual and that signing this form does not release any airline, bus company, hotel or travel agency from liability in the event of negligence on the part of any of these parties.

Further, I agree to behave responsibly and understand that violations of the Worcester State Standards of Conduct are subject to University judicial action as outlined in Student's Rights and Responsibilities.

Waiver of Liability, Covenant Not to Sue, Release, Indemnity, and Hold Harmless Agreement for use of Non-University Vehicles

In consideration for receiving permission not to be transported in a motor vehicle operated by or under the control of  Worcester State University and in furtherance of my request to use transportation of my own choice, I hereby  release, waive, discharge, and covenant not to sue the Commonwealth of Massachusetts,  Worcester State University, and the officers, trustees, agents, and employees of either of them (hereinafter referred to as the “Releases”) from and for any and all liability, claims, demands, actions, and causes of action whatsoever that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the releasees or otherwise, while being transported to or from  the event(s) identified above in a motor vehicle not operated by, or under the control of, Worcester State University.

I am fully aware of the risks and hazards connected with my decision concerning transportation, including the possibility of automobile accidents and the like. I hereby elect to voluntarily be transported in such motor vehicle not owned by, or under the control of Worcester State University. I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including but not limited to death.  

I further hereby agree to indemnify and hold harmless the releasees from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my decision concerning transportation, whether caused by negligence of the releasees or otherwise.

It is my express intent that this agreement shall bind the members of my family and spouse if I am alive and my heirs, assigns and personal representatives if I am deceased and shall be deemed a

Release, waiver, discharge, and covenant not to sue the above named releasees. I hereby further agree that this AGREEMENT shall be construed in accordance with the laws of the Commonwealth of Massachusetts.

In signing this release, I acknowledge and reepresent that I have read the foregoing agreement, understand it and sign it voluntarily as my own free act and deed; that no oral representations, statements or inducements apart from the foregoing written agreement have been made to me in connection with the making of this agreement; that I am at least eighteen years of age and fully competent; and that I execute this agreement with full, adequate and complete consideration, fully intending to be bound by the same.

It is my express intent that this agreement shall bind the members of my family and spouse if I am alive and my heirs, assigns and personal representatives if I am deceased and shall be deemed a release,waiver, dischanrge and covenant notto sue the above named releasees. I hereby further agree that this agreement shall be construed in accordance with the laws of the Commonwealth of Massachusetts.

In signing this release, I acknowledge and represent that I have read the foregoing agreement, understand it and sign it voluntarily as my own free act and deed; that no oral representations, statements or inducements apart from the foregoing written agreement have been made to me in connection with the making of this agreement; that I am at least eighteen years of age and fully competent; and that I execute this agreement with full, adequate and complete consideration, fully intending to be bound by the same.