{"id":225,"date":"2018-03-23T14:12:10","date_gmt":"2018-03-23T14:12:10","guid":{"rendered":"http:\/\/wcsu.wpengine.com\/community-service\/?page_id=225"},"modified":"2018-03-26T16:54:54","modified_gmt":"2018-03-26T16:54:54","slug":"statement-of-due-warning-assumption-of-risk-responsibility-form","status":"publish","type":"page","link":"https:\/\/www.wcsu.edu\/community-service\/western-day-of-service1\/statement-of-due-warning-assumption-of-risk-responsibility-form\/","title":{"rendered":"Statement of Due Warning, Assumption of Risk & Responsibility Form"},"content":{"rendered":"

The following must be read and completed by each person participating in Western Day of Service<\/em>.<\/h4>\n

I \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/u>\u00a0voluntarily agree to participate in the Western Day of Service. <\/em>I am aware that this is a Western Connecticut State University sponsored program and that the university\u2019s Code of Conduct is in force.\u00a0 I am held to the same standards of conduct as if I was on campus.\u00a0 If I am found violating the Code of Conduct while volunteering, I understand I will be subject to the university\u2019s judicial process.<\/p>\n

I am aware of the inherent and\/or latent danger (including but not limited to: risk of serious injury, the hazards of participating in this kind of program, accident or illness, or acts of God) of participating in such activity. I am further aware and have been advised that the University and\/or its personnel will provide minimal supervision during this activity.\u00a0 The following regulations will apply:<\/p>\n

    \n
  1. No minors, without parental or guardian permission.<\/li>\n
  2. No alcohol permitted on bus or mode of transportation or at any time during the program.<\/li>\n
  3. It is the participants\u2019 sole responsibility to strictly adhere to the departure schedule stated prior to trip commencement. Western Connecticut State University will not be responsible for those participants who fail to comply with this regulation.<\/li>\n
  4. Western Connecticut State University assumes no responsibility for participants\u2019 personal property and reserves the right to inspect any\/all packages brought on board the vehicle of transportation.<\/li>\n<\/ol>\n

    Failure to comply with any\/all of the regulations stated above will result in the termination of the participant\u2019s involvement with Western Day of Service<\/em>.<\/p>\n

    Knowing all this, I assume all risks that may arise from or in connection with this activity.\u00a0 In addition, I do hereby agree and warrant to release and hold harmless the state of Connecticut, the Board of Regents of the Connecticut State Colleges and Universities and\/or Western Connecticut State University, its agents and employees, from any and all liability, claims, demands, actions and causes of action whatsoever, arising out of or related to any loss, damage or injury resulting from my participation in this activity.<\/p>\n

    Being eighteen (18) years of age or older, I voluntarily agree to participate in this activity.<\/p>\n

    Student\u2019s Signature:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/u> Date: __________<\/p>\n

    Student\u2019s Printed Name: \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/u><\/p>\n

    Signature of Parent or Guardian if student is under 18 years of age:<\/p>\n

    Parent\/Guardian\u2019s Signature: ________________________________ Date: __________<\/p>\n

    Parent\/Guardian\u2019s Printed Name: _____________________________<\/p>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    The following must be read and completed by each person participating in Western Day of Service. I \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0voluntarily agree to participate in the Western Day of Service. I am aware that this is a Western Connecticut State University sponsored …<\/p>\n","protected":false},"author":44,"featured_media":0,"parent":15,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-225","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/pages\/225","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/users\/44"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/comments?post=225"}],"version-history":[{"count":0,"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/pages\/225\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/pages\/15"}],"wp:attachment":[{"href":"https:\/\/www.wcsu.edu\/community-service\/wp-json\/wp\/v2\/media?parent=225"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}