SDSU Field Trip Release Form

Please read the entire form, then complete the required information and submit this form by clicking the submit button at the bottom of the page. Alternatively, you may print the PDF version of the SDSU Field Trip Release Form and submit it by mail or fax.

WARNING, WAIVER AND RELEASE OF LIABILITY

I understand that participation in this course may require participating in off-campus event, (for example, field trips to Yosemite, Tijuana, the desert and various locations throughout San Diego.)

I hereby waive, release and discharge any and all claims for damages for death, person injury or property damage which I may have, or which hereafter accrue to me, against San Diego State University (the University) as a result of my participation in the event. This release is intended to discharge the University, its trustees, officers, employees and volunteers, and any public agencies from and against any and all liability arising out of or connected in any way with my participation in the event. I further understand that accidents and injuries can arise out of the event which may cause personal injury; knowing the risks, nevertheless, I hereby agree to assume those risks and to release and to hold harmless all of the persons or agencies mentioned above who might otherwise be liable to me (or my heirs or assigns) for damages. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns. It is the intention of the parties hereto that the provisions of this paragraph be interpreted to impose on each party responsibility for their own negligence.

I acknowledge that I have been fully informed of the risks and dangers involved in this field trip. I have been made aware that when using my own vehicle I must have current automobile insurance.

I acknowledge that I have read and fully understand the above Warning, Waiver and Release of Liability.

I further acknowledge that the reasons for my being requested to sign this Release have been fully explained to me and that I understand them.

I am completing and submitting this Release of my own free will and I have not been influenced or coerced by any representative or employee of the State (students under age eighteen (18) must have the signature of their parent or guardian).

* denotes required field

First Name: *

Last Name: *

E-Mail Address: *

Course Information

Department: *

Course number: *

Course name: *

Visitor Application Approval Code

Please obtain this code from the instructor who organized the trip.

Enter valid approval code:

This code is found in an email from Field Stations Program (fieldstationsprogram@mail.sdsu.edu) that announced the approval of your class's Visitor Application (e.g., "20111019-PB-SMITH").

BY CHECKING THIS BOX, I CONFIRM THAT I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ALL OF ITS CONTENTS AND LEGAL EFFECT. I AGREE THAT THIS RELEASE IS CONTRACTUALLY BINDING, AND I SIGN IT OF MY OWN FREE WILL. *

Enter the code you see in the image above: *