Registration Form - Contract

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1 Contact information STUDENT OVERNIGHT TRIP Registration Form - Contract Student s first name Student s last name (as it appears on your Student ID) Address Postal code Telephone Cellphone you will be travelling with Student ID Birth date MM DD YYYY Gender Academic Program Program Year Emergency contact Relation to student Telephone address for parent or guardian! Please!list!any!allergies,!medications!or!medical!conditions,!including!dietary!restrictions.!!! None!!!! Name of trip: Arts Trip to Toronto with Frenzy Tours Dates of trip: October 6 to 8, 2017 You can take part on the trip only if you are in good academic standing. To register, you MUST: o Give to Josie Cavaliere in A-106 by Aug. 31, 2017: a completed and signed waiver form, media release and registration forms from Frenzy Tours and the College a cheque of $435 payable to Frenzy Tours and dated Sept. 5, Write your name and student ID # at the bottom of the cheque. Your deposit cheque is NOT REFUNDABLE after Sept. 5, $10 CASH for administration fees (includes tips) If you wish to extend your trip, you must also submit a letter from your parent(s) or guardian(s) o Notify your teacher(s) if you are missing class o Pay all outstanding debts to the College five working days before departure Cancelling: Students can cancel up to Sept. 5, After that date, they forfeit their full payment. Students may find a replacement up to one week prior to departure.!!! Updated June 8, 2017

2 Rooming: With whom would you like to share a hotel room (four people to a room with two double beds)? We try to make sure that you will be roomed with at least one person you request. If you don t make a request, we will find you a room with students of the same gender Trip organizers who feel that the attitude or behavior of a student threatens the safety, security or smooth functioning of a trip reserve the right to refuse the student s request to participate in the trip. Should the trip be under way, they may send the student home at the student s expense. Student s signature Date Parent/guardian s signature if student is under 18 years old OFFICE USE ONLY Approved by Director of Student Services Approved by Associate Academic Dean Approved by Finance Office!!! Updated June 8, 2017

3 Marianopolis College Thanksgiving Weekend 2017 in Toronto (Please make sure to fill out the entire form. All fields are mandatory) Package: Marianopolis College Thanksgiving Weekend 2017 in Toronto Date: October 6 to 8, 2017 Last Name: First Name: Birth Date: Sex: F M MM DD YYYY Address : City: Province: Postal Code: Telephone: Tel (other): Fax: Person to reach in case of emergency: Telephone: PLEASE MARK THE BOX THAT CORRESPONDS TO YOUR ROOM OCCUPANCY: Quadruple occupation (4) 435$, price per person at 32 students, all taxes included. Quadruple occupation (4) 405$, price per person, at 36 students, all taxes included. Quadruple occupation (4) 370$, price per person, at 40 students, all taxes included. Quadruple occupation (4) 350$, price per person, at 44 students, all taxes included. TERMS AND CONDITIONS (PLEASE READ CAREFULLY): The tour itinerary will be strictly respected. The bus will not wait for those who are not on time. If you miss the bus, you will be responsible to get to the next stop on your own and at your own expense. Frenzy Tours will not be responsible for any of the participants actions. Any damages caused by the participants at any location (ex. hotel room, bus) will be at their own expense. Frenzy Tours will not be responsible for any injuries sustained during the duration of the tour. Frenzy Tours will not be responsible for any lost or stolen items. The consumption of alcohol is strictly forbidden on the bus at all times. By signing below, I agree to the terms and conditions above and confirm that the information I provided is accurate. Signature: x For more information, please contact us at or by at info@frenzytours.com.

4 PARENTAL AUTHORIZATION FOR STUDENTS UNDER 18 AND LIABILITY AND BEHAVIOURAL CONTRACT The undersigned expressly requests that the following agreement be drawn up in English. ARTS TRIP 2017: TORONTO FRIDAY OCTOBER 6-SUNDAY OCTOBER 8 The undersigned parent (defined as legal custodian) or legal guardian (hereinafter referred to as the undersigned ) grants permission to have, a student at Marianopolis College, participate in the Marianopolis Arts Trip to#toronto#from#friday#october#6,#2017#through#sunday#october#8,#2017. Therefore#in#consideration#of#the#above: The undersigned, acting on his or her own behalf and on behalf of his or her child, hereby releases and discharges forever Marianopolis College, its teachers, volunteers, agents and employees, from any and all liability, claims, demands, actions and causes of action of any nature whatsoever and including but not limited to damage, loss, theft or destruction of property, or any injury, including death, howsoever arising, except in the case of gross or wilful negligence, that may result from the act or fault of while participating in the Arts Trip. The undersigned, acting on his or her own behalf and on behalf of his or her child, hereby releases and discharges forever Marianopolis College, its teachers, volunteers, agents and employees, from any and all damages that may be sustained by while participating in said trip of any nature whatsoever and including but not limited to damage, loss, theft or destruction of property, or any injury, including death, howsoever arising, except in the case of gross or wilful negligence. This release shall be binding upon the heirs and successors of the undersigned. The undersigned further states and affirms that he or she is aware of the fact that the aforesaid activity, even under the safest conditions possible, may involve risk or hazard, that he or she is competent to sign this LIABILITY WAIVER AND BEHAVIOURAL CONTRACT and that he or she has read and understands all of the provisions herein contained. Further, I agree that my child will abide by the Trip Itinerary that was issued at the time of payment and will comply with all written and verbal regulations and rules made by trip organizers and College representatives. It is understood that irresponsible behaviour will not be tolerated, especially in connection with alcohol, tobacco and any other non-medical drugs. Failure to comply can result in immediate expulsion from the activity and subsequent sanctions imposed by the College. Any doubts I have about the interpretation of the rules and/or their application will be brought to the attention of the organizer(s) or College representative(s) for the activity. I further understand that it is the responsibility of my child to inform the representative(s) of his/her whereabouts at all times during the trip. As this is a Marianopolis College-sanctioned trip, students are expected to abide by the Policy on Student Conduct. Signature Date Name of parent having legal custody of child or legal guardian (print) Address: Does the student have any medical condition of which we should be aware? YES NO If yes, please give details (e.g. peanut allergy, asthma, etc.). Add a sheet if necessary. N.B. College staff and representatives will be present on this trip to ensure it is properly organized and to handle emergencies. They should not be considered as chaperones and will not act as such. Updated June 8, Please return the completed waiver to Josie Cavaliere, room A-106

5 FOR STUDENTS 18 AND OVER AT THE TIME OF THE TRIP LIABILITY WAIVER AND BEHAVIOURAL CONTRACT The undersigned expressly requests that the following agreement be drawn up in English. ARTS TRIP 2017: TORONTO FRIDAY OCTOBER 6-SUNDAY OCTOBER 8 The undersigned Marianopolis student (hereinafter referred to as the undersigned ) agrees to participate in the Marianopolis Arts Trip to#toronto#from#friday#october#6,#2017#through#sunday#october#8,#2017. Therefore in consideration of the above: The undersigned acting on his or her own behalf hereby releases and discharges forever Marianopolis College, its teachers, volunteers, agents and employees, from any and all liability, claims, demands, actions, and causes of action of any nature whatsoever and including but not limited to damage, loss, theft or destruction of property, or any injury, including death, howsoever arising, except in the case of gross or wilful negligence, that may be sustained by while participating in said trip. The undersigned acting on his or her own behalf hereby releases and discharges forever Marianopolis College, its teachers, volunteers, agents and employees from any and all damages that may be sustained by while participating in said trip of any nature whatsoever and including but not limited to damage, loss, theft or destruction of property, or any injury, including death, howsoever arising, except in the case of gross or wilful negligence. This release shall be binding upon the heirs and successors of the undersigned. The undersigned further states and affirms that he or she is aware of the fact that the aforesaid trip, even under the safest conditions possible, may involve risk or hazard, that he or she is competent to sign this LIABILITY WAIVER AND BEHAVIOURAL CONTRACT and that he or she has read and understands all of the provisions herein contained. Further, the undersigned agrees to abide by the trip itinerary that was issued at the time of payment, and to comply with all written and verbal regulations and rules made by trip organizers and College representatives. It is understood that irresponsible behaviour will not be tolerated, especially in connection with alcohol, tobacco and any other non-medical drugs. Failure to comply can result in immediate expulsion from the activity and subsequent sanctions imposed by the College. Any doubts the undersigned may have about the interpretation of the rules and/or their application will be brought to the attention of the organizer(s) or College representative(s) for the activity. It is also understood that the undersigned accepts the responsibility to inform the representative(s) of his or her whereabouts at all times during the trip. As this is a Marianopolis College-sanctioned trip, students are expected to abide by the Policy on Student Conduct. Signature Date Name (print) Do you have any medical condition of which we should be aware? YES NO If yes, please give details (e.g. peanut allergy, asthma, etc.). Add a sheet if necessary. N.B. College staff and representatives will be present on this trip to ensure it is properly organized and to handle emergencies. They should not be considered as chaperones and will not act as such. Updated June 8, Please return the completed waiver to Josie Cavaliere, room A-106

6 Image Release Form I, (please print name), give permission to Marianopolis College to use (please check one or both)! a photograph of myself! photograph(s) of my creation(s) (including but not limited to photographs, moving images, audio and video recordings, podcasts, school projects, artwork and interviews) in College material (including but not limited to its yearbook, website, posters, calendar, Viewbook, bookmarks, newsletters, agenda cover, letterhead and advertisements). I give the College permission to distribute this material online and in print to a variety of external organizations and institutions, including the media and public. I agree to hold the College and its employees harmless against any possible liability resulting from the use of this material. I hereby certify that I have read the above and fully understand its meaning and effect. I am signing this release freely and voluntarily and in executing this release do not rely on any inducements, promises or representations made by the College or its employees, agents and assigns. (signature) (print name) (student ID) (date) ( ) Arts Trip to Toronto October 6 to 8, 2017 Please return form to Kathryn Haralambous, k.haralambous@marianopolis.edu Marianopolis College, 4873 Westmount Ave., Westmount, QC H3Y 1X9

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