%PDF-1.3 %âãÏÓ 1 0 obj << /Producer (OmniForm Converter for PDF) /Creator (OmniForm) >> endobj 4 0 obj [ /PDF /Text ] endobj 6 0 obj << /Length 7 0 R >> stream BT /F0 14 Tf 0 g 235.68 709.166 Td 99 Tz (University of èßäapp) Tj -73.922 -18.485 Td /F0 16 Tf (Assumption of Risk and Release Form) Tj /F1 12 Tf -70.798 -57.095 Td (Name of Applicant:) Tj 0 -27.36 Td 97 Tz (Date of Birth:) Tj 2.639 -13.68 Td 99 Tz (\(If Applicant is under 18 years of age, a parent or legal guardian must also read and sign) Tj -3.12 -13.92 Td 92 Tz (this form.\)) Tj -0.238 -27.36 Td 99 Tz (Study Abroad Program:) Tj -0.24 -27.598 Td 106 Tz (Study Abroad provides unique opportunities for academic achievement and personal) Tj -0.479 -13.92 Td 108 Tz (growth. Study Abroad also entails special risks. Please discuss both aspects of your) Tj -0.24 -13.92 Td (prospective study abroad experience with a study abroad advisor. This release form) Tj 0.24 -13.92 Td 100 Tz (specifies certain areas of risk that you should know about before you decide to participate) Tj 0.238 -13.92 Td 99 Tz (in a study abroad program.) Tj -0.479 -27.116 Td (I hereby agree as follows:) Tj 1.199 -27.36 Td 106 Tz (1. RISKS OF STUDY ABROAD: I understand that participation in the University of) Tj 16.8 -11.282 Td 99 Tz (èßäapp-) Tj 160.8 -2.639 Td 116 Tz (Study Abroad Program specified above \(''the) Tj -160.8 -13.68 Td 101 Tz (Program''\) may involve risks not found in study at the University of èßäapp. These) Tj -0.24 -13.68 Td 105 Tz (risks include, but are not limited to those risks involved in traveling to and within,) Tj 0.24 -13.68 Td 101 Tz (and returning from, one or more foreign countries; foreign political, legal, social, and) Tj -0.24 -13.68 Td 111 Tz (economic conditions; different standards of design, safety and maintenance of) Tj -0.238 -13.68 Td 102 Tz (buildings, public places and conveyances; local medical and weather conditions; and) Tj 0 -13.68 Td 107 Tz (other matters described on a separate Program Risk form which I have received,) Tj 0 -13.68 Td 101 Tz (reviewed, and initialed, and which is incorporated by reference in this Release Form.) Tj -0.24 -13.68 Td 100 Tz (I have made my own investigation and am willing to accept these risks.) Tj -18 -27.6 Td 106 Tz (2. INSTITUTIONAL ARRANGEMENTS: I understand that the University does not) Tj 17.759 -13.439 Td 102 Tz (represent or act as an agent for, and cannot control the acts or omissions of, any host) Tj 0.482 -13.68 Td (institution, host family, transportation carrier, hotel, tour organizer or other provider) Tj -0.482 -13.68 Td 99 Tz (of goods or services involved in the Program.) Tj -18 -27.839 Td 107 Tz (3. LIMITS OF UNIVERSITY RESPONSIBILITY: I understand that the University) Tj 17.762 -13.442 Td 97 Tz (cannot:) Tj 0 -27.839 Td 99 Tz (a\) Guarantee the safety of participants or eliminate risk from the study abroad) Tj 0 -13.68 Td 98 Tz (environment.) Tj -0.72 -27.6 Td 99 Tz (b\) Monitor or control all the daily personal decisions, choices, and activities of) Tj 0.72 -13.92 Td (individual participants.) Tj -0.482 -27.839 Td (c\) Prevent participants from engaging in illegal, dangerous or unwise activities.) Tj /F1 9 Tf -80.291 -44.385 Td 103 Tz (èßäapp53 \(MAR 99\)) Tj ET .50 w 0 G 2 J 455.664 630.819 m 202.465 630.819 l S 2 J 455.729 607.218 m 202.530 607.218 l S 2 J 458.399 549.119 m 205.2 549.119 l S 2 J 257.04 397.199 m 154.08 397.199 l S endstream endobj 7 0 obj 3258 endobj 5 0 obj << /Type /Page /Parent 3 0 R /Resources << /ProcSet [ /PDF /Text ] /Font << /F0 8 0 R /F1 11 0 R >> >> /MediaBox [ 0 0 612 792 ] /Contents 6 0 R /Annots 18 0 R >> endobj 14 0 obj << /Type /Annot /Subtype /Widget /Rect [ 202 631 456 647 ] /T (FillText6) /FT /Tx /DA (/TiRo 12 Tf 0 g) /Maxlen 16000 /F 4 >> endobj 15 0 obj << /Type /Annot /Subtype /Widget /Rect [ 203 607 456 623 ] /T (FillText7) /FT /Tx /DA (/TiRo 12 Tf 0 g) /Maxlen 16000 /F 4 >> endobj 16 0 obj << /Type /Annot /Subtype /Widget /Rect [ 205 549 458 565 ] /T (Study_Abroad_Program) /FT /Tx /DA (/TiRo 12 Tf 0 g) /Maxlen 16000 /F 4 >> endobj 17 0 obj << /Type /Annot /Subtype /Widget /Rect [ 154 397 257 411 ] /T (FillText2) /FT /Tx /DA (/TiRo 10 Tf 0 g) /Maxlen 16000 /F 4 >> endobj 18 0 obj [ 14 0 R 15 0 R 16 0 R 17 0 R ] endobj 21 0 obj << /Length 22 0 R >> stream 1 w 0 G 0 J 0.72 792 m 0.72 755.52 l S BT /F1 12 Tf 0 g 106.8 713.747 Td 99 Tz (d\) Assure that US standards of due process apply or provide or pay for legal) Tj -0.24 -13.68 Td (representation for participants.) Tj 0.24 -28.08 Td (e\) Assume responsibility for the actions of persons not employed or otherwise) Tj 0 -13.68 Td 100 Tz (engaged by the University, for events that are beyond the control of the University) Tj 0 -13.68 Td (and its subcontractors, or for situations which arise from the failure of a participant to) Tj -0.482 -13.68 Td 99 Tz (disclose pertinent information.) Tj 0 -29.04 Td (f\) Assure that home-country cultural values will apply on the program when these) Tj -0.238 -12.48 Td (differ from those of the host country.) Tj -0.482 -28.559 Td (g\) Be responsible for any injury or loss suffered when traveling independently or) Tj 0 -12.719 Td (otherwise separated or absent from any University- supervised activities.) Tj -18.72 -27.122 Td 104 Tz (4. HEALTH AND SAFETY:) Tj 18.24 -27.36 Td 109 Tz (a\) I have consulted with a medical doctor or Christian Science practitioner and) Tj 17.759 -13.68 Td 107 Tz (program coordinator with regard to my personal medical needs. There are no) Tj 0.24 -12.719 Td 100 Tz (health-related reasons or problems that preclude my participation in this Program.) Tj -18.479 -28.559 Td 111 Tz (b\) I understand that the University does not provide any Accident or Medical) Tj 18.238 -13.68 Td 107 Tz (Insurance during my participation in the above study abroad program. I have) Tj 0 -13.68 Td 102 Tz (arranged, through insurance or otherwise, to meet any and all needs for payment) Tj -0.238 -13.68 Td 100 Tz (of medical costs while I participate in the Program. I recognize that the University) Tj 0.238 -13.68 Td 101 Tz (is not obligated to attend to any of my medical or medication needs, and I assume) Tj -0.238 -13.68 Td (all risk and responsibility therefor. If I require medical treatment or hospital care,) Tj 0.238 -13.68 Td (in a foreign country or in the United States, during the Program, the University is) Tj -0.238 -13.68 Td 99 Tz (not responsible for the cost or quality of such treatment or care.) Tj -18.72 -28.32 Td 103 Tz (c\) I agree to promptly express any health or safety concerns to the program staff or) Tj 18.238 -13.439 Td 99 Tz (other appropriate individuals.) Tj -18.238 -27.842 Td 103 Tz (d\) The University may \(but is not obligated to\) take any actions it considers to be) Tj 17.759 -13.68 Td 101 Tz (warranted under the circumstances regarding my health and safety. I agree to pay) Tj 0.24 -13.439 Td 102 Tz (all expenses relating thereto and release the University from any liability for any) Tj 0 -13.439 Td 97 Tz (actions.) Tj -36.482 -27.842 Td 103 Tz (5. STANDARDS OF CONDUCT:) Tj 17.762 -27.598 Td 115 Tz (a\) I understand that each foreign country has its own laws and standards of) Tj 18.238 -13.68 Td 108 Tz (acceptable conduct, including dress, manners, morals, politics, drug use and) Tj -0.72 -13.68 Td 103 Tz (behavior. I recognize that behavior which violates those laws or standards could) Tj 0.24 -13.68 Td 100 Tz (harm the University's relations with those countries and the institutions therein, as) Tj -0.24 -13.68 Td 103 Tz (well as my own health and safety. I will become informed of, and will abide by,) Tj 0.24 -13.68 Td 107 Tz (all such laws and standards for each country to or through which I will travel) Tj -0.479 -13.68 Td 99 Tz (during the Program.) Tj 391.198 -50.162 Td 84 Tz (2) Tj /F1 9 Tf -483.701 -17.408 Td 103 Tz (èßäapp53 \(MAR 99\)) Tj ET endstream endobj 22 0 obj 3570 endobj 20 0 obj << /Type /Page /Parent 3 0 R /Resources << /ProcSet [ /PDF /Text ] /Font << /F1 11 0 R >> >> /MediaBox [ 0 0 612 792 ] /Contents 21 0 R >> endobj 24 0 obj << /Length 25 0 R >> stream BT /F1 12 Tf 0 g 104.879 713.265 Td 109 Tz (b\) I also will comply with the University's rules, standards and instructions for) Tj 18.96 -13.439 Td 98 Tz (student behavior.) Tj -18.479 -27.36 Td 109 Tz (c\) I agree that the University has the right to enforce the standards of conducts) Tj 17.759 -13.68 Td 101 Tz (described above, in its sole judgment, and that it will impose sanctions, up to and) Tj 0.479 -13.68 Td 103 Tz (including termination from the Program, for violating these standards or for any) Tj -0.958 -13.68 Td 101 Tz (behavior detrimental to or incompatible with the interest, harmony, and welfare of) Tj 0 -13.68 Td 108 Tz (the University, the Program, or other participants. I recognize that due to the) Tj -0.24 -13.68 Td (circumstances of foreign study programs, procedures for notice, hearing and) Tj 0.24 -13.68 Td 107 Tz (appeal applicable to student disciplinary proceedings at the University do not) Tj -0.24 -13.68 Td 104 Tz (apply. If I am terminated from the Program, I consent to being sent home at my) Tj -0.479 -13.68 Td 100 Tz (own expense with no refund of fees or program costs.) Tj -18.482 -28.32 Td 109 Tz (d\) I will attend to any legal problems I encounter with any foreign nationals or) Tj 18.482 -13.68 Td 103 Tz (government of the host country. The University is not responsible for providing) Tj -0.24 -13.68 Td 99 Tz (any assistance under such circumstances.) Tj -36.479 -27.839 Td 113 Tz (6. PROGRAM CHANGES: The University has the right to make cancellations,) Tj 18.238 -13.92 Td 101 Tz (substitutions or changes in case of emergency or changed conditions or in the interest) Tj -0.238 -13.68 Td (of the Program. I understand that the University's fees and program charges are based) Tj 0 -13.68 Td 105 Tz (on current airfares, lodging rates and travel costs, which are subject to change. If I) Tj 0 -13.68 Td 104 Tz (leave or am terminated from the Program for any reason, there will be no refund of) Tj 0 -13.68 Td 106 Tz (fees already paid. I accept all responsibility for loss or additional expenses due to) Tj -0.24 -13.68 Td 105 Tz (delays or other changes in the means of transportation, other services, or sickness,) Tj -0.24 -13.68 Td 102 Tz (weather, strikes, or other unforeseen causes. If I become detached from the Program) Tj 0 -13.68 Td 100 Tz (group, fail to meet a departure bus, airplane, or train, or become sick or injured, I will) Tj 0.24 -13.68 Td 112 Tz (at my own expense seek out, contact, and reach the Program group at its next) Tj -0.24 -13.68 Td 99 Tz (available destination.) Tj -18 -27.598 Td 112 Tz (7. ASSUMPTION OF RISK AND RELEASE OF CLAIMS: Knowing the risks) Tj 17.762 -13.92 Td (described above, and in consideration of being permitted to participate in the) Tj -0.24 -13.68 Td 104 Tz (Program, I agree, on behalf of my family, heirs, and personal representative\(s\), to) Tj 0.24 -13.68 Td 101 Tz (assume all the risks and responsibilities surrounding my participation in the Program.) Tj -0.24 -13.68 Td 100 Tz (I hereby agree to release, hold harmless and indemnify The Curators of the University) Tj -0.24 -13.68 Td 112 Tz (of èßäapp, a public corporation, its officers, employees, and agents, and the) Tj 0.24 -13.68 Td 102 Tz (individual members of the Board of Curators, from and against any present or future) Tj -0.479 -13.68 Td 108 Tz (claim, loss or liability for injury to person or property which I may suffer, or for) Tj -0.24 -13.68 Td 105 Tz (which I may be liable to any other person, during my participation in the Program) Tj 0.24 -13.68 Td 109 Tz (\(including period in transit to or from any country where the Program is being) Tj -0.24 -13.68 Td 92 Tz (conducted\).) Tj -18.24 -27.839 Td 101 Tz (I have carefully read this Release Form before signing it. No representations, statements,) Tj 0 -13.68 Td 105 Tz (or inducements, oral or written, apart from the foregoing written statement, have been) Tj -0.238 -13.68 Td 102 Tz (made. This agreement shall define my responsibilities relating to the Program for which) Tj 0 -12.722 Td 100 Tz (I have qualified at the University of èßäapp-) Tj 318.24 -2.639 Td 99 Tz (, and shall be governed) Tj 109.44 -62.64 Td 76 Tz (3) Tj /F1 9 Tf -485.24 -16.642 Td 103 Tz (èßäapp53 \(MAR 99\)) Tj ET .50 w 0 G 2 J 401.04 106.08 m 304.56 106.08 l S endstream endobj 25 0 obj 4293 endobj 23 0 obj << /Type /Page /Parent 3 0 R /Resources << /ProcSet [ /PDF /Text ] /Font << /F1 11 0 R >> >> /MediaBox [ 0 0 612 792 ] /Contents 24 0 R /Annots 27 0 R >> endobj 26 0 obj << /Type /Annot /Subtype /Widget /Rect [ 305 106 401 119 ] /T (FillText4) /FT /Tx /DA (/TiRo 10 Tf 0 g) /Maxlen 16000 /F 4 >> endobj 27 0 obj [ 26 0 R ] endobj 29 0 obj << /Length 30 0 R >> stream BT /F1 12 Tf 0 g 87.599 713.027 Td 101 Tz (by the laws of èßäapp, which shall be the forum for any lawsuits filed under or incident) Tj 0.24 -13.68 Td 100 Tz (to this agreement or to the Program.) 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