Overnight Form SNEAK PREVIEW This form must be completed in its entirety and presented upon your arrival to campus.
RELEASE OF LIABILITY
STATEMENT OF CONDUCT
For the parent/guardian
For the student
I am the parent/legal guardian of (please print) , who has my permission to be hosted overnight on the campus of Allegheny College. I understand that he/she has signed the Statement of Conduct at right. In the case of an emergency, Allegheny College can reach me by the telephone number listed at bottom right. If I cannot be reached, I authorize Allegheny College to take him/her to the nearest medical facility for the purpose of receiving care, with the understanding that I will be responsible for payment of such services. Furthermore, I understand that my son/daughter agrees to abide by all College policies, including any associated with living in a residence hall during his/her stay, and he/she will adhere to the authority of the administration, faculty and residence life staff.
As a prospective student who has requested an overnight visit to Allegheny College, I take full responsibility for my actions in and among the campus and local community during my stay and will respect the authority of the administration, residence life student staff and faculty with whom I have contact. I recognize that my participation in any social misconduct, including the use of alcoholic beverages or illegal drugs while on campus, may lead to my disqualification for consideration for admission to Allegheny College. Furthermore, I agree to abide by all policies associated with living in a residence hall during my stay, and will respect the authority of all faculty and administrators with whom I have contact.
Student Signature Please list any medical conditions, allergies to medications or current medications:
Student Cell Phone – Provide the number where you may be reached during your campus visit
On behalf of my son/daughter, I hereby release Allegheny College from any and all liability arising out of or in any way related to this trip and not arising directly from negligence of Allegheny College and its community.
Date
IN CASE OF EMERGENCY For the parent/guardian
Student Signature
In the case of an emergency, Allegheny College can reach me at this number:
Parent/Guardian Signature Parent/Guardian Phone Number Date