Blank Participation Agreement
International Participation Agreement and Release &
Deposit Confirmation
Johnson & Wales University - Study Abroad
THIS DOCUMENT CONTAINS A RELEASE OF LEGAL RIGHTS. READ AND UNDERSTAND
BEFORE SIGNING.
The study abroad programs offered by Johnson & Wales University (the “University”) give selected students a unique opportunity to examine their studies from a different perspective and earn academic credit while exploring a new country and culture and gaining new skills. To be selected, students must meet certain eligibility requirements including a minimum GPA and a clean student-conduct record. Students must also demonstrate a high level of professionalism and career focus.
The attached program-specific Fact Sheet outlines the Program’s eligibility requirements including technical requirements, academic focus, credits, cost, international flights, faculty names, withdrawal policy, and sample itinerary. Please review the Fact Sheet as part of this Participation Agreement before signing.
Students are responsible for arriving at the specified location according to the flight parameters set by the Study Abroad Office. Program parameters are e-mailed to students about 4 months prior to departure. During the Program, students will have Faculty Advisor contact information at all times. Students will not be directly supervised during free time (e.g. evenings and designated free weekends) or on any independent excursions they choose to take before or after the Program. Supervision by Johnson & Wales’ faculty and staff ends when the program ends. Students then become responsible for their own travel and living arrangements. Any independent travel arranged by the student will be at the student’s expense.
As a condition to being allowed to participate in the Program, students must agree to and comply with this Participation Agreement and Release & Deposit Confirmation (the “Participation Agreement”). For students under the age of 22, the signature of a parent or guardian is also required. A separate Participation Agreement with an added Parent/Guardian Agreements and Release will be mailed directly to the parent or guardian.
____________________
STUDENT AGREEMENTS AND RELEASE:
I am a student at Johnson & Wales University, and I wish to participate in the Program. I certify that I am at least 18 years old and that my participation in the Program is wholly voluntary. I agree to the terms and conditions of the Program as described in this Participation Agreement including the attached Fact Sheet and in other University publications. I further agree to all of the following:
Health, Safety, and Insurance:I have consulted a medical doctor with regard to my personal medical needs. There are no health-related reasons or problems which preclude or restrict my participation in the Program.
I agree that (a) the University is not obligated to attend to any of my medical or medication needs and I assume all risk and responsibility thereof, and (b) the University may (but is not obligated to) take any actions it considers to be warranted under the circumstances regarding my health and safety, including, without limitation, placing me in a hospital or in the care of a local doctor, or transporting me back to the U.S. by commercial airline or otherwise. I agree to pay all expenses relating thereto, including, without limitation, any emergency medical treatment, ambulances, hospitals or any other charges incurred and release the University from any liability for such actions. I agree that the University is not responsible for the cost or quality of any medical treatment or care that I may receive.
I represent and warrant that I am and will be covered throughout the Program by a policy of comprehensive health and accident insurance which provides coverage for injuries and illnesses I sustain while participating in the Program.
Should a medical emergency require that I depart from the program early, I understand that I may be able to receive medical credit for tuition and student fees from Johnson & Wales University, and any refunds that Johnson & Wales University receives from vendors. Please note however that some vendor fees are not refundable.
Personal Conduct - Compliance with laws, rules, and regulation:I understand that each foreign country has its own laws and standards of acceptable conduct, including dress, manners, morals, politics, and behavior. I agree to abide by all such laws and standards including, without limitation, laws relating to the possession, use, or sale of drugs. I further agree to abide by the instructions, rules, and regulations of any landlord, host institution, host family, transportation carrier, hotel, tour organizer, or other provider of goods or services involved in the Program (each, a “Provider”). I acknowledge and agree that I will be
required by the Provider to execute the documentation of the Provider(s), if any, attached as Exhibit A in order to participate in the Program. I will also comply with the University’s Code of Student Conduct and with the instructions of the Faculty Advisor and other University personnel.
I acknowledge that certain rights, freedoms, and protections that exist in the United States may not be available in all foreign countries, including the right to be free from certain forms of discrimination and harassment and the right to due process, free speech, and free association. I understand that engaging in activities such as political or union activities or demonstrations while in a foreign country may be dangerous or illegal.
I agree that I am solely responsible at my own cost and expense for any civil, criminal or other legal problems I encounter while participating in the Program. I acknowledge that the University will not be responsible for providing any assistance or legal counsel if I do encounter legal problems.
Academic Program: I understand that the Program is an academic program, and I will follow all rules and instructions set for class attendance and participation by the Faculty Advisor and other applicable University personnel, including doing all assigned work and attending all Program-related activities. Noncompliance or failure to complete the preparatory or any other aspect of the Program may result in loss of academic credit without refund, a failing grade which will be reflected in my transcript, and/or dismissal from the program at any time.
Dismissal from the Program: I agree that the University has the right to enforce my agreements in this Participation Agreement and that it can impose sanctions, up to and including immediate dismissal from the Program, if I violate any of these agreements or engage in any behavior detrimental to or incompatible with the interest, harmony, and welfare of the University, the Program, or the other participants, including, without limitation, any behavior that poses a danger to myself or others. Any violations may also be referred to appropriate University officials in the U.S. for further disciplinary or other action. I agree that procedures for notice, hearing, and appeal will not be applicable to actions taken outside of the U.S.
If I am dismissed from the Program (or if I voluntarily leave the Program), I will leave the Program site and return home or to another destination selected by me at the earliest opportunity at my own expense with no refund of fees or tuition paid in connection with the Program. I agree to cooperate with the University in making travel arrangements for my prompt departure from the Program site.
Separation from Group and Independent Travel: In the event that I become detached from the Program due to my failure to meet at an assigned time or any other reason, I agree to seek out and contact the Faculty Advisor and rejoin the Program at the next available destination, all at my own cost and expense. I agree that the University is not responsible for any injury or loss I may suffer when I am traveling independently or am otherwise separated or absent from any University-sponsored activities. The University strongly discourages owning or operating motor vehicles during the course of the Program due to the inherent dangers of driving in a country with different traffic laws, driving habits, and regulations relating to insurance. Should I choose to operate a motor vehicle, I recognize that the University assumes no responsibility, financial or otherwise, in connection with such motor vehicle and my operation thereof.
Program Changes:I agree that the University may make cancellations, changes, or substitutions in the Program at any time in the event of emergency or changed conditions, or if the Faculty Advisor determinates that such changes or substitutions are in the best interest of the Program or its participants.
Risks of Study Abroad:I acknowledge that participation in the Program involves risks not found in study at the University’s U.S. campuses. These risks include:
?Foreign political, legal, social, and economic conditions, including strikes, civil unrest, war, terrorism, and criminal activity;
?Risks associated with travel to, from, and within one or more foreign countries, including delays, cancellations, dishonor of reservations, loss of or damage to baggage or other property, injury to person (including death), or other accidents;
?Local medical conditions, including diseases not common in the United States, quarantine, public health conditions, or limited availability of medical services; and
?Other circumstances beyond the control of the University.
Withdrawal Policy: The $500 study abroad deposit is nonrefundable as of June 1 for fall programs, September 1 for winter programs, December 1 for spring programs, and March 1 for summer programs.
If you submit a withdrawal after the above dates, you will also be charged for a portion of the program cost. The amount you
will be charged (in addition to the $500 deposit) is based on your date of withdrawal as well as the program start date. Please refer to the Withdrawal/Fee Chart for exact amounts.
If you need to withdraw, in order to receive the $500 refund (if applicable) or a reduction in the cost of the program charged to your account, a written withdrawal letter or e-mail will need to be sent to Study Abroad. This letter must be written by you, the student. A telephone call will not be sufficient. The date on which your letter is received will be the formal date of withdrawal.
Withdrawal/Fee Chart
If you withdraw after the deposit is non-refundable: The late withdrawal penalty is:
60+ days before program start date Deposit + $500
30-59 days before program start date Deposit + $1000
15-29 days before program start date Deposit + $2500
1-14 days before program start date Deposit + $3,500
After program start date Deposit + Balance of full program
Assumption of Risk and Release of Claims: I acknowledge that I have read this Participation Agreement carefully and understand its contents. Knowing the risks involved and in consideration of being permitted to participate in the Program, I agree, for myself and on behalf of my family, heirs, and personal representative(s), to assume all the risks and responsibilities surrounding my participation in the Program. To the maximum extent permitted by law, I release and indemnify the University and its officers, trustees, employees, and agents, from and against any present or future claim, loss, or liability for injury to person (including death) or property which I may suffer or for which I may be liable to any other person or entity, arising in connection with my participation in the Program.
__________________________________ ____/____/_____ Name:
(Date) J#:
(Student
Signature)
Program:
Person to be notified in case of an emergency. Multiple phone numbers are most helpful so we can reach the person quickly. In addition, should we need to share written information, a reliable e-mail address is essential.
Phone:
Name: Home
Phone:
Address: Work
Phone:
Cell
E-mail:
I will be 22 years old before my program’s start date: F Yes F No Birth date (mm/dd/yyyy) _____________________
$500 Deposit Requirement Upon Acceptance
?Pay your LOCAL Student Financial Services (SFS) DIRECTLY. Study Abroad does not handle payments.
?An SFS signature is required for this Participation Agreement to be accepted.
?After the deposit, there is no designated payment schedule. Final payment is due in accordance with University Check-In requirements for the term you are studying abroad. SFS can outline payment options should you have questions.
Cash/Check/Credit Card Charge of $500 has been received by SFS, or
Student authorized SFS to hold $500 from a term credit refund, or
SFS has determined that the student’s financial plan is reasonably sufficient to cover the full cost
of the study abroad program inclusive of the $500 deposit.
(SFS Signature) (Date)
Study abroad participants must return this signed document to Study Abroad within two weeks of notification of acceptance: By mail: 8 Abbott Park Place, Providence, RI 02903 By walk-in: 274 Pine Street, Providence, RI By fax: 401-598-2267 By e-mail (scanned and attached as pdf): studyabroad@https://www.wendangku.net/doc/8111908767.html,
JWU Study Abroad Programs
Health, Safety, Special Needs, & Dietary Considerations
Name:
J#:
Even if you do not have any concerns, return this form with your name on it so that we know that your needs are not being overlooked. Thank you.
I. Healthy, Safety, and Special Needs
For your health and safety, if you have a disability or any special needs, contact the Center for Academic Support. We encourage you to discuss any travel plans with your doctors and counselors. If you have any health and safety concerns of which you would like Study Abroad to be aware, please let us know:
II. Dietary Restrictions
Also, if you have any dietary restrictions of which you would like Study Abroad to be aware, please let us know:
Food Allergies:
Vegetarian: ? Yes ? No
Vegan: ? Yes ? No
Other: