Please update your web browser or disable Compatibility View.

Worldwide Travel Alert Waiver Addendum

All CSB/SJU students participating in a Short-Term International Program are required to read and acknowledge the following Addendum.  Please submit this on-line form no later than Midnight on Thursday, May 12.

 

ADDENDUM TO THE SHORT-TERM, OFF-CAMPUS PROGRAM WAIVER AND RELEASE FORM FOR DESTINATIONS UNDER A U.S. DEPARTMENT OF STATE TRAVEL WARNING

The following shall be incorporated into the Short-Term, Off-Campus Program Waiver and Release Form for _________________________ (Student) and the College of Saint Benedict/Saint John’s University (CSB|SJU).

By signing below, I, ________________________, hereby acknowledge my understanding and full agreement to the following and further acknowledge that I am signing this Addendum of my own free will and based upon my own assessment of the relative pros and cons associated with my decision to participate in the external program I have selected:
1. I understand that the United States Department of State issued a Worldwide Travel Alert on May 1, 2011. I have read and understand the significance of the US DOS Travel Alert. (http://www.travel.state.gov/travel/cis_pa_tw/pa/pa_5447.html) "The U.S. Department of State alerts U.S. citizens traveling and residing abroad to the enhanced potential for anti-American violence given recent counter-terrorism activity in Pakistan." The above Travel Alert is set to expire on August 1, 2011.


2. I understand that the Travel Alert advises "U.S. citizens in areas where recent events could cause anti-American violence are strongly urged to limit their travel outside of their homes and hotels and avoid mass gatherings and demonstrations. U.S. citizens should stay current with media coverage of local events and be aware of their surroundings at all times."


3. I understand and acknowledge that I have personally elected to participate on this program given the U.S. State Department’s Travel Alert. I understand that CSB|SJU or any of their officers, employees or agents and further acknowledge cannot be held responsible for the quality or conditions of the program in which I have personally made the decision to participate.


4. For myself, my heirs, and successors and assigns, I hereby release, indemnify and hold harmless CSB|SJU from any and all losses, costs, damages, liability or expenses (including reasonable attorneys' fees), resulting in any way or arising out of my decision to participate and/or my participation in the program.


5. I release CSB|SJU of all liability and waive all claims against CSB|SJU with respect to my participation in the program I have selected.


6. I understand that it is my personal responsibility to ensure any and all coverage and protection I wish to have for any accident, disability, repatriation or any loss related to my person, my property or my activities throughout my participation in the program. It is my responsibility to determine and acquire the appropriate levels and applications of insurance coverage and policies.

7. I fully understand and agree that I am responsible for any expenses not covered by any insurance coverage plans and policies.

8. I acknowledge that I will register my presence abroad with the appropriate U.S. Embassy through the U.S. Department of States’ Smart Traveler Enrollment Program (STEP). (https://travelregistration.state.gov/ibrs/ui/)
I understand and acknowledge that the Short-Term, Off-Campus Program Waiver and Release Form and this Addendum set forth the entire agreement with respect to the subject matter of the off-campus program and supersedes any and all prior understandings and agreements, whether oral or written.

By my electronic signature, I represent and acknowledge that in signing the Short-Term, Off-Campus Program Waiver and Release Form and this Addendum I am not relying on and have not relied upon any representation or statement made by any other person associated with CSB|SJU with regard to the subject matter, basis or effect of the Short-Term, Off-Campus Program Waiver and Release Form, this Addendum or otherwise that is not contained in the Short-Term, Off-Campus Program Waiver and Release Form or this Addendum.

Your Demographic Information








By completing the Form above, and typing my name here, I confirm that I am eletronically signing this ADDENDUM TO THE SHORT-TERM, OFF-CAMPUS PROGRAM WAIVER AND RELEASE FORM FOR DESTINATIONS UNDER A U.S. DEPARTMENT OF STATE TRAVEL WARNING


By clicking "Submit", I consent to the information provided above and am submitting my signature electronically.

 

DON'T FORGET!

  • Complete the Health and Emergency Contact Form
  • Submit the Waiver & Release Form to your trip leader