WHEREAS, I wish to participate in the field trip described below:
(Short description of field trip) (date)
as part of the course entitled "_____________________________________________.Ē
WHEREAS, I understand this to be part of my course work at
I will not possess or use illicit drugs or alcohol while participating in class work. Lawful use of alcohol is permitted only during my free time.
I will follow the student code of conduct as described in The Catís Tale.
I assume full responsibility for any personal activities in which I participate that are outside the scope of required course work. I understand that the University does not provide coverage for the use of my personal vehicle.
To the best of my knowledge, I am in good health and suffer no disability or condition which renders my participation in trip activities medically inadvisable.
I consent to the administration of emergency first aid and authorize UVM personnel to obtain emergency medical care on my behalf should it be necessary. I understand I will be responsible for expense associated with such care.
By signing below, I acknowledge that I have read, understand and agree to abide by this agreement.
Signature of Participant Date
Name (please print)
Signature of parent or guardian Date
(if participant is under 18 years of age)