PLEASE READ THIS DOCUMENT CAREFULLY AND IN ITS ENTIRETY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT IN WHICH YOU ARE GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE, AND ACCEPTING IMPORTANT RESPONSIBILITIES AND OBLIGATIONS. Mid Michigan College considers student participation in organized, off-campus activities to be an important part of a student’s learning experience. However, off-campus activities may involve certain risks, which may not be reasonably anticipated or avoided. In order to participate, each student must read the following form carefully, complete the information, provide their signature, and submit this form.

The name you enter below must match your government-issued ID.

By my signature below, I acknowledge the following.

Acknowledgment of Participation

• I choose to participate in travel as part of Mid Michigan College.

Adherence to Policies

• I understand that I am bound by and will comply with all of Mid Michigan College policies, including the Student Code of Conduct; the Campus Non-Discrimination, Harassment, & Sexual Misconduct Policy; the Title IX Sexual Harassment Policy; the Alcohol & Other Drug Policy; and any travel-related policies. I have read and understand these Policies and understand that while traveling, I will be representing Mid and will adhere to these Policies.
• I understand that the consumption of alcohol is strictly prohibited.
• I acknowledge that the use of narcotics, illegal drugs, or other controlled substances is strictly prohibited.
• I understand that possession or use of any kind of firearm or weapon is prohibited.
• I understand that should I be found drinking, intoxicated, using drugs, or in possession of a weapon, I may face disciplinary action and be sent home at my own expense.
• I agree that due to the circumstances of travel, any procedures for Hearings, Appeals, or Notices applicable to Mid’s judicial process may apply at the discretion of the Trip Organizer.
• I may not purchase, possess, and/or use any illegal or unauthorized drugs during the duration of the travel, including free time. I understand that illegal drug purchase, possession, or use jeopardizes me, other students, and the travel itself. I understand that violation of this rule of conduct may result in immediate expulsion from the travel. I further understand that I would be responsible for the costs of transportation home.
• Students found in violation of the Student Code of Conduct by a dean, vice president, or designee will be subject to appropriate interim or disciplinary action, and any associated costs (e.g., flights, ground transportation, accommodations, meals, etc.) to return home will be at the student’s expense.
• I will comply with all of Mid’s standards, guidelines, and instructions for student conduct and behavior. I acknowledge and understand that my compliance and submission to the guidelines is important to the success of the travel and will influence Mid’s willingness to permit future similar activities. I agree that in its sole judgement, Mid has the right to enforce the standards and it may impose restrictions, up to and including disciplinary proceedings and removal from the travel for violating the standards or for any behavior that is disruptive, detrimental, or incompatible with the interest, harmony, and welfare of the travel or its participants. I also agree to adhere to all directions and instructions of the Trip Organizer and Chaperones during the course of the travel and that failure to do so may result in the imposition of restrictions.

Assumption of Risk

• I understand that participation in travel involves risks not encountered during routine college study, including risks involved in traveling to, within, and returning from, destinations.
• I understand the risks involved in participating in travel, and I hereby assume all risks and responsibilities for my own health and safety, whether or not stated in this Waiver/Release.
• I hereby certify that I have consulted with my healthcare provider as needed regarding my participation in this travel program. I affirm that I have no known or suspected medical conditions, risks, or problems that would: (1) preclude or restrict my participation in travel, (2) make my participation medically inadvisable, or (3) pose a risk to myself or others during travel. I acknowledge that any intentional or negligent failure to disclose relevant health information shall constitute a material breach of this agreement and may result in immediate removal from the travel program at my own expense, including all associated transportation costs.
• I hereby waive, release, and hold harmless Mid Michigan College, its Board,
  administration, faculty, support staff, sponsors, supervisors, employees, and
  representatives, from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my participation in travel, except for those arising from gross negligence, willful misconduct, or other conduct that cannot be waived under Michigan law. I understand and acknowledge that this Waiver/Release discharges Mid from any liability or claim against it with respect to any bodily injury, personal injury, illness, death, monetary loss, or property damage that may result from my participation in travel.
• I understand that Mid assumes no responsibility for or obligation to provide
  financial assistance or other assistance, including but not limited to medical,
  health, or disability insurance, in the event of injury, illness, death, accident,
  monetary loss, or property damage. I further agree to indemnify Mid, its Board, administration, faculty, support staff, sponsors, supervisors, employees, and representatives from any actions brought against it as a result of my acts, negligence, or omissions.

Expectations & Responsibilities

• I understand that I am expected to represent Mid in a positive, mature, and exemplary manner.
• I will treat the other participants, Trip Organizer, Chaperones, and individuals I may meet, respectfully. I will be courteous to others and will not create any disturbing situations that may disrupt others.
• I understand that it is my responsibility to stay with the group and participate in all planned activities/events.
• I will stay informed of and adhere to our schedule in a punctual, prepared manner.
• I will not venture out alone and will carry my Driver’s License/ID with me at all times.
• I am solely responsible for my personal belongings.
• I will be accountable for bringing the appropriate amount of money, medications, and other needed items for the duration of any travel. If I have problems, I will communicate with the Trip Organizer or Chaperones to seek an effective solution.
• I will wear appropriate clothing (nothing offensive, with holes, tears, or anything improper). Apparel will be presentable and comfortable (including shoes).
• I will plan for weather changes (umbrella, raincoat, sunscreen, etc.).
• If I am removed from the travel, I consent to going home at my own expense without a refund from the College for any monies I may have paid to participate in the travel.
• I recognize and am in agreement that in the event that I become detached from the group, fail to meet a departure bus, airplane, train, or other conveyance; become sick or injured and unable to travel, or choose to travel early, or remain after the travel has officially concluded, I will bear all responsibility for all associated expenses.
• I assume responsibility for my actions, understanding that the circumstances of the travel likely require a standard of behavior that may differ from that which is applicable on campus. If I encounter legal problems while participating in this travel, I will attend to the matter personally at my own expense and will hold Mid harmless therefrom. I further understand that Mid is not responsible or under obligation to provide any assistance under such circumstances, and that Mid cannot obtain release from jail if I am jailed for any reason.
• I understand that I am responsible for the safety of my personal possessions, documents, money, travel tickets (as applicable), and any other property. I assume full financial responsibility for all costs and expenses incurred by me in connection with the travel. This includes without limitation, the financial responsibility for lost or damaged property from any cause whatsoever, and for any damage or destruction to the property of third parties of which I am at fault.

Liability

• I expressly acknowledge and understand that Mid Michigan College acts solely as a facilitator and not as an agent, representative, partner, or joint venturer with any host institution, accommodation provider, food service provider, tour operator, transportation company, or other third-party service provider connected with this travel program. Mid has no control over and assumes no responsibility for the actions, omissions, or services of these independent providers. I further recognize that Mid: a) is not responsible or liable for any injury, damage, loss, accident, delay, or other irregularity created by any company or person engaged in providing or performing services involved in the travel; b) is not responsible for any irregularity which may be caused by a vehicle defect or the negligence or default of any company or person engaged in providing or performing any of the services involved in this travel; c) is not responsible for losses or expenses, including but not limited repatriation expenses, due to sickness, weather, strikes, hostilities, natural disasters, acts of terrorism, or the personal decision to leave the travel early or any other related causes; and d) is not responsible for any disruption of travel arrangements or any consequential additional expenses that may be incurred therefrom.
• I acknowledge and agree to accept all responsibility for, and acknowledge that Mid is not responsible for any loss, damage, destruction, or theft of my personal belongings; and that I have adequate funds to replace such belongings. I release and will hold Mid harmless therefrom.
• I understand that should I choose alternate transportation to and/or from the travel that the College is providing, I must complete the Mid Transportation Waiver before utilizing said alternate transportation.
• I agree to a) consult with a medical doctor with regard to my personal medical needs and confirm that there are no health-related reasons or problems which preclude or restrict my participation in this travel; b) arrange for adequate medical and hospitalization insurance to meet any and all needs for payment of medical and hospital expenses while engaged in the travel; c) assume all risk and responsibility, therefore; d) consult and arrange with a medical doctor to receive the appropriate inoculations/shots for this travel (vaccination information can be found by visiting the Center for Disease Control and Prevention at https://wwwnc.cdc.gov/travel/destinations/list) if applicable; e) pay for any and all medical and hospitalization expenses incurred and; f) release Mid from any legal responsibility for payment of my medical, medication, or hospitalization requirements and from any other claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered to me or to my dependents/companions in connection with an emergency or health problem during my participation in the travel.
• In the event of illness or injury, I hereby authorize the Trip Organizer or
  Chaperones, in their sole discretion, to obtain emergency or medical treatment on my behalf if I am unable to do so myself. I expressly accept full financial responsibility for any and all costs related to such medical treatment, including but not limited to emergency services, hospital care, medications, medical procedures, and medical transport. This authorization shall remain valid for the duration of the travel program unless explicitly revoked in writing. I also authorize them to arrange to transport me back to
  Michigan for medical treatment. I agree that I am fully responsible for any and all expenses, including transportation costs, associated with or in any way related to my medical care. I also authorize the College or its agents to release medical information obtained from me to a care provider or others in the event of a health emergency or as needed to provide reasonable accommodations. I hereby release and forever discharge Mid from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered to me in connection with an emergency or health problem during my participation in the travel.
• I will not hold myself out as possessing the power or authority to bind or create liability for Mid.

Travel

• I understand that it is within Mid’s discretion to change accommodations, travel, or other arrangements as it deems necessary. I understand that the College is not responsible for, nor does it represent or act as an agent for, and thus cannot control the acts or omissions of any host institution or service providers. This includes those who provide transportation, tours, dining, or sleeping accommodations. I understand that Mid may cancel this travel; withdraw any part of the travel, and make alterations, deletions, or modifications in the itinerary as deemed necessary by the College or Trip Organizer.

Again, I understand that I am responsible for my personal conduct while traveling as part of any Mid Michigan College-sponsored travel or trips. I am expected to adhere to all of Mid’s Policies and obey all applicable provisions of laws of the state/area in which the travel takes place. I fully comprehend that Mid is under no obligation to intercede or protect me from legal consequences for any violation of law that I may be responsible for.

You must answer 'Yes' to the waiver/release statements below in order to travel as part of Mid Michigan College.

Your participation in this trip requires your affirmative acceptance ('Yes' response) to all statements below. If you do not accept all statements, you will be ineligible to participate and the Trip Organizer will be notified accordingly.

Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier you can report the barrier at midmich.edu/reportaccessibilitybarrier.

In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.