SECTION D: PARENT AUTHORIZATION AND UNDERSTANDINGS
1. PARENTAL PERMISSION TO PARTICIPATE:
My son/daughter has my permission to apply for and to participate in an
international study experience sponsored by Roman Institute of Scholarship and Excellence, LLC.
2. MEDICAL RELEASE AUTHORIZATION:
I/We the legal guardians of hereby authorize Roman Institute of Scholarship and Excellence, and its representatives, to seek medical attention on behalf of the student
named above in the event of sickness, accident, or other emergency
during the program. I/We also authorize any physician to release any
information acquired in the course of examination or treatment. I/We
certify that the above information is correct and that the
information on illness in Section A is correct. This authorization
shall be valid for the entire duration of the Roman Institute of Scholarship and Excellence program.
3. ZERO-TOLERANCE DRUG AND SEX POLICY
I/We understand that RISE has a zero-tolerance policy for any kind of drug
use, including tobacco and alcohol products, as well as toward any
kind of sexual activity during the program. RISE officials will
exercise their right to send students home, at their parent’s
expense, if a student is found to be taking part in such activities.
4. NEWS RELEASE:
I/We the legal guardians of hereby authorize Roman Institute of Scholarship and Excellence and its representatives to respond to media inquiries regarding participation
in the program.
5. GENERAL AGREEMENT AND RELEASE
1. I, the undersigned (and my parents or guardian if I am a minor), an
applicant for a program of the Roman Institute of Scholarship and Excellence
(“RISE”), acknowledge that I have read and accept the
terms and conditions set forth in this application and on the RISE
website (www.romaninstitute.net) .This agreement is a legally binding
contract.
2. I unconditionally release RISE from any claims for damage, injury,
loss, or expense of any nature resulting from events beyond its
control, including without limitation acts of God, war, strikes,
crime, terrorism, sickness or quarantine, government restrictions or
regulations. This release also applies to any losses arising from the
use of any vehicle or from the selection of, or from any act or
omission by, any RISE affiliate, bus or car rental agency, steamship,
airline, railroad, taxi or tour service, hotel service, hotel
restaurant, school, university or other firm, agency, company or
individual, unless the loss is caused by the gross negligence of RISE.
3. I understand that I am responsible for exercising caution and common
sense at all times to avoid injuries, and that RISE cannot provide
supervision or support during periods of independent travel.
4. I agree that if I become ill or incapacitated, RISE may take such
actions as it considers necessary under the circumstances, including
securing medical treatment for me and transporting me to the United
States. I release RISE from any liability relating to this medical
care. I also authorize RISE to take whatever action it deems to be
necessary and in my best interest (including transporting me out of
the host country or back to the United States, at my own, or my
parents’ expense) in the event of political unrest or any other
unforeseen event or condition. If RISE incurs any expense on my
behalf, I (and my parents) agree to make immediate repayment upon my
return.
5. I will comply with RISE’s rules, standards and instructions, and
understand that failure to do so may result in being sent home at my
(or my parents’) expense, with no refund. I understand that my
participation may be terminated if I am expelled from RISE or
otherwise disciplined by RISE or civil authorities, or if RISE, in its
sole discretion, determines that my conduct is incompatible with the
interests, harmony, comfort or welfare of other students. I (and my parents) agree to indemnify RISE
if I do anything that causes RISE to sustain financial loss or
liability.
6. I understand that future Institute publicity material may include
statements made by participants or their photographs, and I consent
to such use of my comments or photographs of me.
7. I understand that RISE reserves the right to make changes,
cancellations, or substitutions in cases of emergency or changed
conditions, emergency or based upon the interest of the group. I
understand that, if I leave the program or if I am expelled from the
program as discussed in (5) above, there will be no refund of tuition
fees.
8. I understand that obtaining a passport and any other required travel
documents is my sole responsibility.
9. I understand that RISE is unable to guarantee single rooms or rooms
with private baths or showers.
10. This agreement will be effective when my application is accepted by
RISE and shall be governed by the laws of the State of Massachusetts.
11. This agreement cannot be modified except in writing by RISE.
12. I agree that any dispute with RISE that is not settled informally will
be submitted to binding arbitration, to be conducted in substantial
accordance with the rules of the American Arbitration Association.
The location of the arbitration and identity of the arbitrator will
be decided by mutual agreement, with the costs to be shared equally
between the parties, and the decision of the arbitrator shall be
final. By signing this agreement, I understand that I am giving up my
right to have any claim against RISE decided in Court before a judge
or jury.
13. References in this agreement to “RISE” shall include the
Roman Institute of Scholarship and Excellence, LLC, and all of its agents,
employees, affiliated companies, campus directors, chaperones, group
leaders, teachers, host school and school officials. All references
to “parents” of the applicant shall include the legal
guardian or other adult who is responsible for the applicant.
14. All applicants under 18 years of age must have this section
completed.
I am the parent or legal guardian of the above (minor) applicant. I
have read the catalog and foregoing Agreement and Release, and agree
to be bound thereby:
6. VERIFICATION
I have completed/reviewed the above information, and it is accurate and complete.
7. ACADEMIC STREAM
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