MUSKEGON COMMUNITY COLLEGE
Student Liability Release Form
NAME of RSO______________________________________________________________
TRAVELING TO __________________________________________DATE____________
This form must be signed by all participating students/staff, completed, and returned to the
Student Life Office prior to departure.
In consideration of the College’s participation and recognition in the registration of the RSO
and its activities, I acknowledge that membership and activity in the RSO’s programs and
events may, upon occasion, involve risk of physical injury or illness; further, I assume all risks
and hazards incidental to the RSO’s activities, including travel, and agree to release, discharge
and hold harmless Muskegon Community College, its board members, officers, employees and
agents from any claims arising out of or relating to any physical injury or illness that may
result from my travel, participation or involvement in the activities of the RSO described
above.
Student Signatures
Address
Telephone
Student #
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Insurance
In all aspects of club activities, students and club advisors are participating in an MCC sponsored and approved
activity. MCC insurance coverage protects the College, not individuals, against various insurance claims.
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Registered Student Organization Advisor's Signature
6/15/2010
Date
_