RELEASE FORM (TRAVEL WAIVER) COVER SHEET

One week before the trip, the contact representing the student organization should complete this cover sheet and ensure that a "Participation Agreement Including Assumption of Risk and Release from Liability" is completed for each person going on the trip and attached to this cover sheet. Turn the completed forms in to the Office of Student Activities. For your information, a copy of this cover sheet will also be sent to the Campus Police in case someone needs to contact one of the students in an emergency situation.

Organization:  
Contact Name: Email:
College: Phone:

Date of Trip
Destination: State/Country:
Emergency Phone Address:

Multiple Destinations (if applicable):
Dates
Emergency Phone  

Purpose of Trip:  
Date Leaving: Date Returning:
Mode of Transportation:
Flight Info (if applicable):
Comments:
 

Clearly Print Names and Colleges/Departments of Those Attending: