College of Liberal Arts & Sciences
Department of Psychology, Undergraduate Advising
135 Psychology Building
PO Box 112250
Gainesville, FL 32611-2250
352-273-2115
352-392-7985 Fax
MEMORANDUM
TO:
[name of student]
FROM:
Undergraduate Coordinator, Department of Psychology
DATE:
[date]
RE:
Waiver of Liability Insurance from PSY4949 volunteer site
You have requested to do community work at [agency] for the [semester] semester, [year], to
receive [#] credits for your volunteer efforts at this site. This site has informed us that they do
not have liability insurance that would cover you while you are a volunteer. The University of
Florida and the State of Florida do not provide this insurance. Lack of such insurance means that
in the unlikely chance you were sued by one of the clients or staff, you could suffer financial loss
as a result. You may or may not have personal insurance that would cover liability in this case,
but we recommend strongly that if you sign this waiver, you determine if you have such
insurance for yourself and obtain such insurance if you do not.
If you have any questions, feel free to contact us at 273-2115, or email to psychadvising@ufl.edu.
I, [name of student], have read and do understand the above memorandum, and agree to receive
University of Florida credit for volunteering at [agency] for the [semester] semester, [year],
knowing that I will not be covered for liability from this site, and I am not covered for liability
from the University of Florida or the State of Florida. I agree to hold harmless the University of
Florida and the State of Florida and its employees in the unlikely event that a liability claim is
filed against me.
Signature
Date
Witness’s Signature
Date
The Foundation for The Gator Nation
An Equal Opportunity Institution