Johns Hopkins University | War Zones Task Force

Final Report of the War Zones Task Force
July 2005

Appendix I: 2005 Graduate Student Study Release Template

I, ____________, am a graduate student at The Johns Hopkins University, in the Department of ____________ in the School of ____________. I am planning to conduct some of my graduate studies abroad during the academic year ____________ in ____________ (locations) for the ____________ (period of time) .

I understand and assume the wide variety of risks associated with any travel to and living in a foreign country, including but not limited to terrorism, crime, and lack of access to health care comparable to that available in the United States, dangers associated with public or private transportation and the safety of road systems and other means of transportation. I understand that every country has its own laws and culture and that I am responsible for my own actions, activities and behavior while I am outside of the United States, and I recognize that I may be responsible for all aspects of my living and studying while I am abroad. I understand that I may suffer injury, exposure to disease, or death, as well as losses to my property.

I understand I can and should obtain information about the conditions in foreign countries from the U.S. State Department website, the World Health Organization website, and the Center for Disease Control.

I represent that I am covered throughout the travel abroad program and throughout my absence from the United States by a policy of comprehensive health and accident insurance which provides coverage for illnesses or injuries I sustain or experience while abroad. I release The Johns Hopkins University from any responsibility and liability for my injuries, illness, medical bills, charges or similar expenses.

I have voluntarily chosen to make this trip of my own free will. I agree to release and hold harmless The Johns Hopkins University and its employees and agents from any and all liability and damages or losses I may suffer to my person or my property or both, which arise out of or occur during my participation in the foreign study and research, except if the danger or losses are caused by the gross negligence or willful misconduct of University employees.

I agree that this Student Release is to be construed in accordance with the laws of the State of Maryland, and that if any portion of this agreement is held invalid, the remainder of the agreement shall continue in full force and effect. I agree that any dispute about this agreement or claim I or my heirs, executors or assigns might make will be brought in the state or federal courts of Maryland. I acknowledge that I have read this entire document, and I voluntarily agree to its terms.

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Date

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Signature

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Printed Name

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