Student Trip Waiver

STUDENT APPLICATION PAPERWORK GROUP TRIPS | 18 years +

It is necessary that all participants complete this online application and provide the Institute of Study Abroad Ireland with the information requested. These forms must be returned to ISAI at least one month before the start date of the trip.

Faculty /trip organiser must ensure that a complete application is received for every person attending the program. This includes faculty, any extra attendees and students. The ISAI Code of Conduct applies to every person in the group, irrespective of whether they are faculty, community members, partners/spouses/family members, or students.

No participant will be accepted to the program without completed application.

Any issues of difference between the Institute of Study Abroad Ireland policies and the incoming group organisers must be discussed and documented in writing before the group travel.

All participants must supply details of a personal travel insurance policy which includes trip disruption and trip cancellation cover. No participant will be accepted to the program without proof of a personal travel insurance policy.

Please fill out the below forms to confirm your participation in our study abroad trip to Ireland

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Please write the name of your group and dates of travel

Are you a student or a faculty member?(Required)

Student

Faculty Member

Community Member

Are you the lead faculty member?(Required)

Each institution should have ONE lead faculty member. Lead faculty members will provide us with further information about the overall group.

Number of Students attending this program(Required)

Number of accompanying faculty/supervisory adults attending this program(Required)

Name (s) of other faculty or supervisort adults attending this program(Required)

Flight Transcript - Please upload a copy of your group flight transcript (Both legs)(Required)

Max. file size: 2 GB.

Rooming List - Please upload a suggested rooming list for your students - allocation of 2 or 3 per room. Please include preferred faculty arrangements also. We strongly advise that students are consulted when rooming lists are being completed.

Max. file size: 2 GB.

What is your position within the faculty?(Required)

Name of Institution/School(Required)

Please select your group from the list below(Required)

Trip Start Date(Required)

Trip End Date(Required)

Write the name of your lead faculty or instructor who is accompanying your group

Section One - Personal Information

First Name (As per Passport)(Required)

Last Name (As per Passport)(Required)

Name (As student prefers)(Required)

Gender/Preferred Pronouns(Required)

Home Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Contact Phone Number (Home)(Required)

Contact Phone Number (Cell)

Email(Required)

Date of Birth(Required)

Month

Day

Year

Please upload a recent headshot photo of yourself(Required)

Accepted file types: jpg, jpeg, png, Max. file size: 2 GB.

Name of Educational Institution(Required)

City and State of your Educational Institution(Required)

Section One - Personal Information (Dietary Requirements & Medical info)

Please indicate any dietary requirements.

Vegetarian, Gluten Free and Vegan meal plans are accommodated . FOOD ALLERGIES MUST BE RECORDED AND STUDENTS MUST INFORM THE DIRECTORS AND MEAL PROVIDERS ON ARRIVAL OF ANY SEVERE ALLERGIES.

Please outline any medical conditions that may be relevant: Include any details of any medications required.(Required)

Is there any relevant issue with alcoholism or substance abuse?(Required)

Is there any relevant issue of eating disorders?(Required)

Is there any relevant issue of mental health/wellness ?(Required)

If the answers to any of the above is ‘yes’, we ask you to discuss any needs with us so we can best support you.

Please indicate any allergies(Required)

Please indicate anything else you feel is relevant under health. All information will be treated in strictest confidence.

Section 2: Statement of Due Warning and Assumption of Risk

Voluntary Participation Agreement(Required)

I have been advised and am aware of the inherent and / or latent danger (including but not limited to: risk of serious injury, the hazards of travel, accident or illness, or acts of God) of participating in such an activity. I am aware and have been advised to have a medical examination prior to participating in this activity to ensure that I am in good physical health. I am aware that this program outdoor activities and there is a risk of accident or injury. Further, I am aware and have been advised that I must be properly covered by adequate travel insurance policy.

Program activities may include outdoor activities such as surfing, hiking, kayaking, swimming, team sports, moderate walking, options such as horseback riding, bodyboarding and other sporting activities. I understand that I am free to withdraw from any of these activities, but by participating, I have been advised and am aware of the inherent and / or latent danger (including but not limited to: risk of serious injury, the hazards of travel, accident or illness, or acts of God) of participating in such an activity.

I understand that this is a group program, and that group standards must be observed. I agree that THE INSTITUTE OF STUDY ABROAD IRELAND and the Director, Niamh Hamill shall have the right to terminate my enrolment for failure to maintain these standards, for actions or conduct which the Program and /or course director considers to be detrimental to or incompatible with the interest, harmony, comfort or welfare of the course and group as a whole. I understand that if I am asked to leave the program, I must bear responsibility for all costs including immediate return to USA. I understand that the Program and/ or course director reserves the right to change assignments and to make alterations in itineraries at any time without prior notice.

I have and do hereby note, understand, and assume all risks, which may arise from or in connection with this activity. The terms hereof shall serve as a release and assumption of risk for my heirs, executors, assigns and administrators and for all members of my family.

I voluntarily agree to participate in the Institute of Study Abroad Ireland Program

Signature(Required)

Initials of Signee(Required)

Signature Date(Required)

Month

Day

Year

Section 2: Consent Form For Emergency Treatment

Name of Student(Required)

Permanent Home Address(Required)

Name of Emergency Contact(Required)

Emergency Contact Home Telephone Number(Required)

Emergency Contact Work Telephone Number(Required)

Emergency Contact Address(Required)

Doctor's Name(Required)

Doctor's Contact Number(Required)

Alternative Medical Contact

Section 3: Code of Conduct

Conditions of Acceptance(Required)

Conditions of Acceptance I understand that I am subject to The Institute of Study Abroad Ireland regulations, program guidelines and the laws of the host country (Republic of Ireland). Our objective is to provide a safe space for all our visitors. Our code of conduct is based on personal responsibility to behave in a way that does not endanger your safety and well-being, and the safety and well-being of others on the trip,

By accepting a place with The Institute of Study Abroad Ireland, I understand that participants who engage in any of the following acts, may be subject to disciplinary actions or immediate dismissal from the program:
•violation of the alcohol and drug policy
•criminal behaviour or violation of local laws
•excessive absences
•behaviour that puts others’ safety and well-being at risk
•disruptive behaviour
•physical or verbal abuse of any kind.
•property damage
•disorderly, indecent, or obscene conduct or language
•abusive or threatening language towards other students, staff or staff at the host institution
•violent, demeaning, humiliating, or threatening behaviour towards others
•harassment
•theft
•possession or use of firearms, dangerous weapons or chemicals is strictly prohibited.
• obstruction or disruption of teaching, research,
administration, or other activities associated with the administration of the program.

The legal age to purchase or drink alcohol in Ireland is 18 years. The pub culture is a part of the Irish culture, and we include activities such as music sessions in Irish pubs. We expect all participants over the age of 18 years to behave responsibly, and adhere to whatever policy has been advised by their college.

This is a totally drug-free programme, and no abuse or use of illegal drugs will be tolerated.
Smoking is illegal in any indoor facility and restricted to designated areas outside. Smoking is not permitted during field trips, tours or group activities. We ask you please to only smoke in designated smoking areas, and never with non-smoking members of your group.

I understand that I am subject to The Institute of Study Abroad Ireland regulations, program guidelines and the laws of the host country (Republic of Ireland)

Disciplinary Structures(Required)

Visiting groups are subject to the terms and conditions of their own institution, and faculty leaders and institutional policies will be supported by ISAI.

The Institute of Study Abroad Ireland reserve the right to decide what is considered inappropriate behaviour: This will include any form of bullying, excessive drinking, using narcotics, failing to turn up for classes or group activities, or disrespect of any other participants or staff. Any disrespect to staff here will result in immediate action: Staff are responsible for safety and wellbeing of all students: they will not compromise safety standards at any time.

The Institute of Study Abroad Ireland accommodation must be respected. Non-program visitors are not allowed in student apartments at any time, and students must reside in their assigned accommodation. A full inventory is provided for students when they arrive and will be checked before departure. Students are responsible for property in their accommodation and will collectively be responsible for anything damaged or absent.

The Institute of Study Abroad Ireland program is famous for the comfortable and welcoming atmosphere provided. The above situations are very rarely the case, and the majority of students are excellent participants. We wish to reassure parents and participants that no antisocial behaviour will be allowed to spoil the great atmosphere here for anyone.

I understand that I am subject to The Institute of Study Abroad Ireland disciplinary structures

Signature(Required)

Initials of Signee(Required)

Signature Date(Required)

Month

Day

Year

Section 4: Outdoor Activities

Consent(Required)

I am aware that during the course of the ISAI Program I may have the opportunity to engage in a variety of recreational activities. The opportunities will be organized by ISAI (Institute of Study Abroad Ireland), the organization whose program the students will be attending.

I understand there are risks associated with my participation in these activities. By signing this form, I hereby consent to participating in such activities and confirm that I will not hold ISAI or my institution responsible for any harm or injury suffered by me while participating in these types of activities.

Please note: These activties will nto icnlude any dangerous/extreme sports, but may include activities such as hiking, and beginner surfing lessons.

I hereby release Institute of Study Abroad Ireland (ISAI) and (name of institution) , its employees, agents and affiliates from and hold each of them harmless against, any and all liabilities, including but not limited to claims for negligence, that they may jointly or severally incur to us, our heirs, executors, administrators, successors and or assigns, in respect of any claim, suit, or cause of action, including legal fees and expenses of litigation, on account of any personal injury, bodily injury, death, loss of health, financial loss or damage to property directly or indirectly sustained by as a result of our participation in the types of activities described in this release or other similar activities. Notwithstanding the foregoing, this release does not apply to intentional wrongdoing or gross negligence on the part of ISAI or its employees or volunteers.

I understand that in order to participate in this program, I am expected to behave responsibly, and in a manner that will not put my own self, or any of my fellow students or faculty, or faculty and staff of ISAI at risk. I understand that any actions that are considered by my supervisors/ leaders to be anti-social or unsafe, for my well-being or the well-being of others, may result in my withdrawal from the program.

A Facebook blog will be posted on the Institute Study Abroad Facebook page. We ask your permission to use photographs taken during the trip for our blog, and social media platforms. We do not post detailed names, addresses or personal information. If you would prefer not to be photographed or video-ed, please advise us of same in writing. The Facebook page is https://www.facebook.com/studyabroadireland Twitter is @isaireand Instagram @studyabroadireland

I agree to the Outdoor Activity and Content Policy

Signature(Required)

Initials of Signee(Required)

Signature Date(Required)

Month

Day

Year

Section 5: Customs and Travel Documents

Please upload a picture of your flight transcript (Arrival)(Required)

Max. file size: 2 GB.

Please upload a picture of your flight transcript (Departure)(Required)

Max. file size: 2 GB.

Travel Policy(Required)

You will need a valid passport for your travel. You should make sure you apply for a passport at least three months before your date of travel.

If you are a passport holder of a country that is not the USA, please check this website https://www.dfa.ie/travel/ visas/visas-for-ireland/ for visa requirements.

If you are travelling and are not yet 18 years old, you must also have a letter of permission from your parent/ guardian.

A personal travel insurance policy is a requirement of joining ISAI programs.

A personal travel insurance policy is a wise investment. You can insure yourself against any delays or cancellation in travel, and also you can insure yourself against trip disruption and cancellation. Air travel can be disrupted by weather events at any time of year, and by other events beyond control. If you become unwell or have an accident while travelling, you should have access to the best, immediate healthcare, or have the option to return home if you need to. Our experience is that few students have the above issues, but if and when they do, this is when travel insurance is essential. Without travel insurance, healthcare, travel, and disruption can become extremely expensive, - with it, you can do what you need to do without this added worry. Both the USA Government and the Irish Government strongly recommend you do not travel without a personal travel policy.

ALL STUDENTS TRAVELLING WITH A GROUP ARE REQUIRED TO HAVE TRAVEL INSURANCE. The Institute of Study Abroad requires all students to have a valid travel insurance policy cover for their trip to Ireland. We will require proof of the policy before you travel, and those without travel insurance will not be allowed to join the trip. The Institute of Study Abroad can recommend LewerGlobal, and you can connect with them here: https://www.lmkstudentinsurance.com/student-insurance-international/

Faculty Members can avail of the same provider.

I agree to the Travel policy.

Insurance Policy Number(Required)

Insurance Provider(Required)

Insurance Provider Address(Required)

Does your insurance policy covers for outdoor sports e.g. surfing, climbing, canoeing etc.?(Required)

Yes

Signature(Required)

Initials of Signee(Required)

Signature Date(Required)

Month

Day

Year