COBM Student Travel Informed Consent, Release, Waiver & Expressed Assumption of Risk on Transportation
COBM Student Travel Informed Consent, Release, Waiver & Expressed Assumption of Risk on Transportation
The East Stroudsburg University in its sponsorship of various student activities and programs sometimes licenses the use of its vans and mini-vans (its “vehicles”), or provides reimbursement for traveling expenses where private individuals provide their own means of transportation, to participants in those activities and programs.
Furthermore, as part of that Waiver and Release, students/ participants who provide their own vehicular transportation shall acknowledge that their private insurance provides primary coverage with respect to all risks, and any insurance coverage provided by the individual is secondary to that primary coverage. Failure to abide by these conditions, as well as the ESU Student Code of Conduct, may result in a denial of further use of the vehicles by the sponsored club, and/or denial of reimbursement for the sponsored club’s past and future traveling expenses.
I realize that vehicular transportation to and from COBM-sponsored activities, whether participating as a driver or passenger, and using vehicles supplied by COBM or by private individuals, although not an inherently dangerous activity, nonetheless, also entails risks of injury to the persons, and to property. I understand the conditions regarding the use of vehicles, whether supplied by the COBM or private individuals, in COBM-sponsored activities and programs, as aforesaid, and will abide by same, and accept the consequences as heretofore provided.
Further, I acknowledge the contagious nature of pandemic viruses (including but not limited to COVID-19) and voluntarily assume the risk that I may be exposed to or infected by participating in COBM-sponsored activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death.
In accepting these risks I expressly and explicitly release, discharge, and waive any and all responsibility of East Stroudsburg University of Pennsylvania, the Pennsylvania State System of Higher Education, and the East Stroudsburg University College of Business and Management faculty, employees, officials, or agents of any of the foregoing, pursuant to, or pertaining, or arising from, in any manner, injuries to my person or property as a result of my participation in this event.
Participant Name
Participant Name
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Last
Email
Phone
Phone
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For Participants of Minor Age
This is to certify that I, as parent/Guardian with legal responsibility for this participant, do herewith consent and agree to his/her release as provided above, of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releases from any and all liabilities incident to my minor child’s involvement or participation in COBM practicum, field experience and programs as regards the provision of transportation, unless arising from the recklessness and wanton disregard of the Releases.
Parent/Guardian Name
Parent/Guardian Name
First
Last
Parent/Guardian Phone#
Parent/Guardian Phone#
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