I, ________________________________, do desire and intend to participate in Indiana State University’s Travel Seminar program in _________________________________ ("Program").

I understand that there are certain dangers, hazards, and risks inherent in international travel and the activities included in the program, and I agree to assume all risks and responsibilities related thereto. I hereby waive and release all claims against Indiana State University, its Trustees, the officers, agents, employees, the Indiana State University Foundation and its Travel Seminar program, from any and all obligations to me, my heirs, executors and assigns for any injury, loss, damage, accident, delay or expense resulting from my participation in the Program, including, but not limited to, that which may result from the use of any vehicle, strikes, war, weather, sickness, quarantine, or government restrictions or regulations.

I do further agree to indemnify and save harmless Indiana State University, its Trustees, officers, agents, employees, the Indiana State University Foundation, and the Travel Seminar program, with regard to any financial obligations or liabilities that I may personally incur or any damage injury to my person or property or to the person or property of others that may occur while participating in the Travel Seminar Program including attorney’s fees and court costs.

I understand that Indiana State University, its Study Abroad program, officers, agents, employees, and the Indiana State University Foundation are not responsible for any injury or loss whatsoever suffered by me during periods of independent travel, and the Travel Seminar Program has full authority to take whatever action it may consider to be warranted under the circumstances regarding my health and safety, and I fully release each of them from any liability for such decisions or actions as may be taken in connection therewith. In the event that the Travel Seminar Program or its agents advance or loan any monies to me or incur special expense on my behalf while I am abroad, I agree to make immediate repayment upon my return.

I herby assure Indiana State University that I have consulted with a medical doctor with regard to my personal medical needs such that I can and do further state that there are no health related reasons or problems, which preclude my participation in the Program.

I understand that I am responsible for and that I am required to maintain adequate health, life, accident, and repatriation insurance coverage while I am a participant in the Travel Seminar Program.

I understand that in the event that I choose to cancel my enrollment or voluntarily withdraw from the program at any time, I agree to bide by the terms set forth under the "Cancellation Policy" in the itinerary/brochure or other related documents. I understand that it is my responsibility to read the itinerary/brochure and related documents carefully before signing this agreement.

I understand that Indiana State University, its Travel Seminar Program, Trustees, officers, agents, employees, and the Indiana State University Foundation reserve the right to cancel trips, and to make alterations in trip and itineraries as may be required for Travel Seminar Programs.

In signing this Release, I acknowledge and represent that I have become fully informed of the content of this waiver of liability and hold harmless agreement by reading it before signing it, and by signing this document as my own free act and deed confirm that no oral representations, statements, or inducements, apart from the foregoing written statement have been made.

Signed this _____ day of _____________________, 20 _____.

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