Mont Ste-Anne Ski/Snowboard Trip (January 8 - 10, 2025)

STATEMENT OF LIABILITY/LIABILITY WAIVER

The undersigned hereby acknowledges that I am (my son/daughter is) a student at John Abbott College (or a friend of a student) and wish to participate in a trip/activity to:

Place: Mont Ste-Anne, Quebec

Date: January 8 - 10, 2025

and understand that I (they) am not required by the College academic program to make this trip, but that this extra-curriculum activity (trip) is organized voluntarily by individual staff of the College Student Activities Department, as a para-service for which the College is not legally responsible.

In consequence whereof, I hereby agree to hold harmless, individually and severally,

Bill Mahon, Ski Evolution and their staff, and Student Activities Department

Staff Name(s)

and John Abbott College and/or its employees, agents, préposés, mandatories and/or their heirs or successors and legal representative and/or the liability insurers of the aforementioned parties, for any and all liability for damages of any kind or nature whatsoever suffered due to my (their) participation in this trip, it being expressly understood and agreed that I accept all risks involved. I understand that the aforesaid trip, even under the safest conditions possible, may be hazardous.

Moreover, it is understood that I agree that the above people involved in this trip shall not be considered to be a préposé or an employee of John Abbott College acting in the scope of his (their) function(s) for the organization and/or execution of this trip and being in no way under the control or supervision of the College while doing so.

My (their) participation in this activity and event is made on my (their) own will, at my (their) risks and perils, after the nature of same has been duly explained prior to my (their) engagement in it.

Who will be participating?

Student 18+ Student under 18

Signee Information

First Name *

Last Name *

My Date of Birth *

Phone *

Email Address *

My (Their) Student ID number is (if a non-student write N/A)*

AGREEMENT WAIVER

You must agree to all conditions in order to participate in this activity. If you do not agree, please speak with Bill Mahon in Student Activities H-159.

I understand that this trip is non-refundable, for whatever reasons, if I (my son/daughter) wish to cancel.*
I agree

I (my son/daughter) understand that I (they) have paid a $60 security deposit which will be refunded to me (them) provided that there are no damages or other charges assessed against me (them) or the condo I am (they are) assigned to.*
I agree

I (my son/daughter) understand that this trip is for registered visitors only and unregistered guests are prohibited from staying in the condos. I understand that I (they) maybe subject to disciplinary actions and eviction from the condo. *
I agree

I agree that I (my son/daughter) must respect the student code of conduct of John Abbott College and the rules set out by Ski Evolution. Any breach may result in disciplinary actions up to and including dismissal from the trip and prompt return to John Abbott College at my (their) sole expense.*
I agree

EMERGENCY CONTACTS

Emergency Contact*

Please list an one or two emergency contact name and their relationship to you

List one or two numbers where we may reach them in case of emergency>*

HEALTH QUESTIONNAIRE

Please answer YES or NO. If you answer yes, please specify.

Do you (they) had any medication allergies? If yes specify*

Do you (they) have any food allergies? Intolerances? If yes please specify*

Do you (they) have any allergies that require you to carry an Epipen? *

Do you (they) have any particular dietary needs? If yes, please specify. (Note that the participant will be personally responsible for ensuring food safety in case of dietary restrictions)*

Has a medical doctor ever diagnosed you (them) with a chronic illness? If yes specify*

Do you (they) currently take medication or other treatments for the above chronic illness? If yes, specify*

Do you (they) suffer from a mental/psychological condition? If yes, please specify*

Have you (they) ever been treated in hospital for this condition?

Are you (they) followed by a specialist for this mental / psychological condition? *

Do you (they) suffer from any serious limitations that may affect your mobility or your ability to engage in field related activities? (Ex very painful joints, knees, foot, hips or back pain etc). If yes please specify*

Please indicate any prescribed drugs that will be taken with you (them) on this trip. If yes, please indicate the name and dosage*

HEALTH QUESTIONNAIRE DISCLAIMER

I hereby certify that, to the best of my knowledge, this medical form is complete in all of its details. I authorize John Abbott College to communicate this information to the chaperone of the trip, and to relevant heath authorities in case of emergency. Furthermore, should it be necessary for me (them) to return home due to medical reasons, I (they) assume all transportation costs not covered by travel health insurance.*
I agree

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.