Traveler First Name:

Traveler Last Name:

Staff/Student ID Number (if applicable):

Trip Destination (you must select one from the list):

Passport

Please upload a copy of the information page from your passport (accepted file types are .pdf, .jpg, .jpeg, .png).

Visas-ETA-ETIAS

Will you be traveling to any countries in the UK (Great Britain, Northern Ireland, or Scotland)?

**An ETA is required for entry into the UK. You can access information on how to apply for an ETA by going to the "Visit the UK" website. 

Please save and upload a copy of your ETA approval documentation (accepted file types are .pdf, .jpg, .jpeg, .png).

Will you be traveling to any countries in the EU's Schengen region (even just for a layover)?

**A complete, updated list of these countries can be found by clicking here.

Please save and upload a copy your ETIAS approval documentation (accepted file types are .pdf, .jpg, .jpeg, .png).

Drivers License

Please upload a picture of the front of your driver's license. (accepted file types are .pdf, .jpg, .jpeg, .png).

Please upload a picture of the back of your driver's license. (accepted file types are .pdf, .jpg, .jpeg, .png).

Health Insurance

Please upload a picture of the front of your insurance card (accepted file types are .pdf, .jpg, .jpeg, .png).

Please upload a picture of the back of your insurance card (accepted file types are .pdf, .jpg, .jpeg, .png).

Travel Waiver

Please download, complete, and upload this waiver form (accepted file types are .pdf, .jpg, .jpeg, .png).

RULES AND REQUIREMENTS: I agree to follow all University policies and procedures and all requirements of the Activity.  I acknowledge that the University can, in its sole discretion, terminate my participation in the Activity. I understand that if the University terminates my participation, I am solely responsible for the cost of return travel.   

INFORMED CONSENT:  I have received and reviewed the travel itinerary and syllabus for the Course and understand the risks involved in traveling, too, within and from Location, including but not limited to foreign, political, legal, social, and economic conditions, language barriers, safety hazards, crime, disease, consumption of food, civil unrest or hostilities, terrorism, war, natural disasters and weather conditions, and negligent first aid operations or medical treatment.   

INDEMNITY:  I, on behalf of myself, my personal representatives, heirs, executors, administrators, agents, and assigns, agree to hold harmless, defend and indemnify the Releasees from any and all liability, including any and all claims, demands, causes of action (known or unknown), suits, or judgments of any and every kind (including attorneys’ fees), arising from any injury, property damage or death that I may suffer as a result of my participation in the Program, regardless of whether the injury, damage or death is caused by the Releasees or otherwise, unless the injury, damage or death is caused by the Releasees’ negligence or intentional acts. 

PERSONAL BELONGINGS:  I understand and acknowledge that the University is not responsible for the loss of any personal belongings or property that I sustain during my participation in the Program, including but not limited to the loss of credit cards, cash, luggage, and other items. 

PERSONAL MEDICAL INSURANCE:  I agree to purchase and maintain during the term of the Program personal medical insurance that includes repatriation and medical evacuation coverage in an amount not less than $50,000 per person, per occurrence and is applicable in the countries to which I am traveling, as indicated on my itinerary for the Program.  I further acknowledge that I am responsible for the cost of any and all medical and health services I may require as a result of participating in the Program. 

MEDICAL CONSENT:  I understand and agree that Releasees do not have medical personnel available at the location of the Program.  In the event of any medical emergency, I do authorize and consent to any x-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment, and hospital care that the University personnel deem necessary for my safety and protection.  I understand and agree that Releasees assume no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment. 

CHOICE OF LAW:  I hereby agree that this Agreement is made in South Dakota, and South Dakota law, irrespective of its conflict of law rules, will govern it.  I understand that I may engage legal counsel to fully explain any terms of this Agreement to me before I sign it. 

The venue and jurisdiction of any lawsuit concerning this Agreement shall be determined in accordance with the Federal Rules of Civil Procedure.   

Agreement of USF Participant/Student Traveler: I have read this agreement and fully understand its terms.  I am aware that this agreement includes a release and waiver of liability, an assumption of risk, and an agreement to indemnify the Releasees. 

By entering your first and last name, you hereby provide your electronic signature and indicate your agreement to the terms of this waiver.