Williams College

Winter Study Program


Student Waiver/Travel Agreement


W1234567
Name*
e.g. 2024
Type of Winter Study*
Where will you be for your course?*

Winter Study Travel Course

Winter Study 99 or Internship

International Travel

Does the country you are traveling to have a level 3 or 4 travel advisory?*


Additional Information

Please provide additional information about where you are staying.

Address*
Please indicate mobile phone number (ideal) or email.


Passport

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Williams College Winter Study
Acknowledgment and Assumption of Risks and Release Agreement
for Students Participating in Winter Study Courses Abroad

This is a release of legal rights; review carefully and understand before signing. Please keep a copy for your records. 

In consideration and as a condition of The President and Trustees of Williams College (“Williams College”) approving my participation in the above winter study course ("the Course"), I hereby agree to the following: 

1. Understanding of terms of Williams College’s approval:

I understand that failure to abide by the requirements of the Course as outlined by the professor (if it is a Williams course) or as outlined by the proposal (if it is an independent study course), may jeopardize my receiving academic credit for winter study.

I likewise acknowledge that, notwithstanding my being off campus for winter study, my failure to adhere to the standards of code of conduct may also jeopardize my receiving academic credit for winter study and may subject me to disciplinary proceedings.

I understand that should I change my Course from that listed above to another course of study off-campus, the terms and conditions of this Agreement form still apply. 

2. Medical circumstances: 

If I have any physical or mental health circumstances that may affect my study abroad experience, I understand and agree that it is in my best interest to discuss the situation with my physician, the course instructor or sponsor, and a dean.

3. Risks of travel and study abroad: 

I understand and acknowledge that participation in the Course may involve risks not found in study at Williams College’s campus. I understand and acknowledge that these may include, but are not limited to, risks involved in and from: traveling to and within, and returning from, one or more foreign countries; war, political or social unrest, and terrorism; disease; different political, legal, social, law enforcement, and economic conditions; different standards of design, safety and maintenance of buildings, public places and conveyances; different standards as to the availability and provision of medical care; and different weather conditions.

I also understand and acknowledge that while participating in the Course and living abroad I may experience risks and/or differences relating to educational systems, academic expectations, recognition of civil rights, lack of accessibility and accommodations for persons with disabilities, alcohol and drug use, relationships and gender issues. 

I have made my own inquiry and investigation into such risks and/or differences, and am willing to accept them as a condition of my participation in the Course. I understand and acknowledge that although this Course may be approved, sponsored, administered, or organized by Williams College, the College is not in a position to prevent any injury, illness, loss or harm that I may suffer by virtue of participating in this Course, and I am not relying on the College or any of its employees or agents to do so. I acknowledge that my participation in the Course is wholly voluntary. 

I understand and acknowledge that if this is an independent study course, Williams College does not administer the Course, and Williams College does not represent or act as an agent for, and cannot control the acts or omissions of, any host institution, host family, transportation carrier, place of lodging, tour organizer or other provider of goods and services in connection with the Course.

4. Release of liability: 

Having examined and understood the above, I HEREBY EXPRESSLY ASSUME THE RISK OF ANY PERSONAL INJURY OR DEATH, ANY LOSS OR DAMAGE TO PROPERTY, AND ANY OTHER LOSS OR HARM OF ANY KIND THAT I OR ANYONE ELSE MAY INCUR IN CONNECTION WITH THIS COURSE, AND (for myself and my heirs, executors, administrators and assigns) I HEREBY RELEASE WILLIAMS COLLEGE AND ALL OF ITS OFFICERS, TRUSTEES, EMPLOYEES AND AGENTS FROM ANY LIABILITY, DAMAGES OR CLAIMS OF ANY KIND RELATING IN ANY WAY TO ANY SUCH ILLNESS, INJURY, HARM, OR LOSS, INCLUDING BUT NOT LIMITED TO ANY CLAIM ARISING FROM THE ALLEGED NEGLIGENCE OF WILLIAMS COLLEGE OR ANYONE ACTING ON ITS BEHALF. 

I agree to indemnify Williams College for any and all claims, liabilities, and expenses of any nature arising out of, or in any way relating to, my participation in the Course or my own acts or omissions during my participation in the Course. 

I agree that if any portion of this Acknowledgment and Assumption of Risks and Release Agreement is deemed unenforceable, all other provisions will remain in full force and effect. I understand and agree that no oral representations or statements by Williams College or its representatives will effectively alter the acknowledgments, agreements and representations stated above. This agreement shall be governed by the laws of the Commonwealth of Massachusetts, which shall be the forum for any lawsuits filed under or incident to this Agreement or the Course. 

BY SIGNING THIS DOCUMENT, I ACKNOWLEDGE THAT I HAVE READ AND CAREFULLY REVIEWED AND UNDERSTAND IT IN ITS ENTIRETY, AND I HEREBY AFFIRM MY AGREEMENT TO ITS TERMS AS A CONDITION OF MY PARTICIPATION IN THE COURSE. I FURTHER AFFIRM THAT I AM 18 YEARS OF AGE OR OLDER.

Use your mouse or finger to draw your signature above.

Domestic Travel


Additional Information

Please provide additional information about where you are staying.

Address*
Please indicate mobile phone number (ideal) or email.
Williams College Winter Study
Acknowledgment and Assumption of Risks and Release Agreement
for Students Participating in Off-Campus Courses (including internships)

This is a release of legal rights; review carefully and understand before signing. Please keep a copy for your records.

In consideration and as a condition of The President and Trustees of Williams College (“Williams College”) approving my participation in the above winter study course ("the Course"), I hereby agree to the following:

1. Understanding of terms of Williams College’s approval:

I understand that failure to abide by the requirements of my Course as outlined by the professor (if it is a Williams course) or as outlined by the proposal (if it is an independent study course), may jeopardize my receiving academic credit for winter study.

I likewise acknowledge that, notwithstanding my being off campus for winter study, my failure to adhere to the code of conduct may also jeopardize my receiving academic credit for winter study and may subject me to disciplinary proceedings.

I understand that should I change my Course from that listed above to another course of study off-campus, the terms and conditions of this Agreement form still apply.

2. Medical circumstances:

If I have any physical or mental health circumstances that may affect my off-campus study experience, I understand and agree that it is in my best interest to discuss the situation with my physician, the course instructor or sponsor, and a dean.

3. Risks of travel and study off-campus:

I understand and acknowledge that participation in the Course may involve risks not found in study at Williams College’s campus. I understand and acknowledge that these may include, but are not limited to, risks involved in and from: traveling to and within, and returning from the destination; different legal, social, public health, sanitary, security, law enforcement, and economic conditions; different standards of design, safety and maintenance of buildings, public places and conveyances; different standards as to the availability and provision of medical care; and different weather conditions.

I have made my own inquiry and investigation into such risks and/or differences, and am willing to accept them as a condition of my participation in the Course. I understand and acknowledge that although the Course may be approved, sponsored, administered or organized by Williams College, the College is not in a position to prevent any injury, illness, loss or harm that I may suffer by virtue of participating in the Course, and I am not relying on the College or any its employees or agents to do so. I acknowledge that my participation in the Course is wholly voluntary.

I understand and acknowledge that if this is an independent study course, Williams College does not administer this Course, and Williams College does not represent or act as an agent for, and cannot control the acts or omissions of, any host institution, host family, transportation carrier, place of lodging, tour organizer or other provider of goods and services in connection with the Course.

4. Release of liability:

Having examined and understood the above, I HEREBY EXPRESSLY ASSUME THE RISK OF ANY PERSONAL INJURY OR DEATH, ANY LOSS OR DAMAGE TO PROPERTY, AND ANY OTHER LOSS OR HARM OF ANY KIND THAT I OR ANYONE ELSE MAY INCUR IN CONNECTION WITH THIS COURSE, AND (for myself and my heirs, executors, administrators and assigns) I HEREBY RELEASE WILLIAMS COLLEGE AND ALL OF ITS OFFICERS, TRUSTEES, EMPLOYEES AND AGENTS FROM ANY LIABILITY, DAMAGES OR CLAIMS OF ANY KIND RELATING IN ANY WAY TO ANY SUCH ILLNESS, INJURY, HARM, OR LOSS, INCLUDING BUT NOT LIMITED TO ANY CLAIM ARISING FROM THE ALLEGED NEGLIGENCE OF WILLIAMS COLLEGE OR ANYONE ACTING ON ITS BEHALF.

I agree to indemnify Williams College for any and all claims, liabilities, and expenses of any nature arising out of, or in any way relating to, my participation in the Course or my own acts or omissions during my participation in the Course.

I agree that if any portion of this Acknowledgment and Assumption of Risks and Release Agreement is deemed unenforceable, all other provisions will remain in full force and effect. I understand and agree that no oral representations or statements by Williams College or its representatives will effectively alter the acknowledgments, agreements and representations stated above. This agreement shall be governed by the laws of the Commonwealth of Massachusetts, which shall be the forum for any lawsuits filed under or incident to this Agreement or the Course.

BY SIGNING THIS DOCUMENT, I ACKNOWLEDGE THAT I HAVE READ AND CAREFULLY REVIEWED AND UNDERSTAND IT IN ITS ENTIRETY, AND I HEREBY AFFIRM MY AGREEMENT TO ITS TERMS AS A CONDITION OF MY PARTICIPATION IN THE COURSE. I FURTHER AFFIRM THAT I AM 18 YEARS OF AGE OR OLDER.
Use your mouse or finger to draw your signature above.

On-Campus/Local

Williams College Winter Study
Acknowledgment and Assumption of Risks and Release Agreement
for Students Participating in Off-Campus Courses (including internships)

This is a release of legal rights; review carefully and understand before signing. Please keep a copy for your records.

In consideration and as a condition of The President and Trustees of Williams College (“Williams College”) approving my participation in the above winter study course ("the Course"), I hereby agree to the following:

1. Understanding of terms of Williams College’s approval:

I understand that failure to abide by the requirements of my Course as outlined by the professor (if it is a Williams course) or as outlined by the proposal (if it is an independent study course), may jeopardize my receiving academic credit for winter study.

I likewise acknowledge that, notwithstanding my being off campus for winter study, my failure to adhere to the code of conduct may also jeopardize my receiving academic credit for winter study and may subject me to disciplinary proceedings.

I understand that should I change my Course from that listed above to another course of study off-campus, the terms and conditions of this Agreement form still apply.

2. Medical circumstances:

If I have any physical or mental health circumstances that may affect my off-campus study experience, I understand and agree that it is in my best interest to discuss the situation with my physician, the course instructor or sponsor, and a dean.

3. Risks of travel and study off-campus:

I understand and acknowledge that participation in the Course may involve risks not found in study at Williams College’s campus. I understand and acknowledge that these may include, but are not limited to, risks involved in and from: traveling to and within, and returning from the destination; different legal, social, public health, sanitary, security, law enforcement, and economic conditions; different standards of design, safety and maintenance of buildings, public places and conveyances; different standards as to the availability and provision of medical care; and different weather conditions.

I have made my own inquiry and investigation into such risks and/or differences, and am willing to accept them as a condition of my participation in the Course. I understand and acknowledge that although the Course may be approved, sponsored, administered or organized by Williams College, the College is not in a position to prevent any injury, illness, loss or harm that I may suffer by virtue of participating in the Course, and I am not relying on the College or any its employees or agents to do so. I acknowledge that my participation in the Course is wholly voluntary.

I understand and acknowledge that if this is an independent study course, Williams College does not administer this Course, and Williams College does not represent or act as an agent for, and cannot control the acts or omissions of, any host institution, host family, transportation carrier, place of lodging, tour organizer or other provider of goods and services in connection with the Course.

4. Release of liability:

Having examined and understood the above, I HEREBY EXPRESSLY ASSUME THE RISK OF ANY PERSONAL INJURY OR DEATH, ANY LOSS OR DAMAGE TO PROPERTY, AND ANY OTHER LOSS OR HARM OF ANY KIND THAT I OR ANYONE ELSE MAY INCUR IN CONNECTION WITH THIS COURSE, AND (for myself and my heirs, executors, administrators and assigns) I HEREBY RELEASE WILLIAMS COLLEGE AND ALL OF ITS OFFICERS, TRUSTEES, EMPLOYEES AND AGENTS FROM ANY LIABILITY, DAMAGES OR CLAIMS OF ANY KIND RELATING IN ANY WAY TO ANY SUCH ILLNESS, INJURY, HARM, OR LOSS, INCLUDING BUT NOT LIMITED TO ANY CLAIM ARISING FROM THE ALLEGED NEGLIGENCE OF WILLIAMS COLLEGE OR ANYONE ACTING ON ITS BEHALF.

I agree to indemnify Williams College for any and all claims, liabilities, and expenses of any nature arising out of, or in any way relating to, my participation in the Course or my own acts or omissions during my participation in the Course.

I agree that if any portion of this Acknowledgment and Assumption of Risks and Release Agreement is deemed unenforceable, all other provisions will remain in full force and effect. I understand and agree that no oral representations or statements by Williams College or its representatives will effectively alter the acknowledgments, agreements and representations stated above. This agreement shall be governed by the laws of the Commonwealth of Massachusetts, which shall be the forum for any lawsuits filed under or incident to this Agreement or the Course.

BY SIGNING THIS DOCUMENT, I ACKNOWLEDGE THAT I HAVE READ AND CAREFULLY REVIEWED AND UNDERSTAND IT IN ITS ENTIRETY, AND I HEREBY AFFIRM MY AGREEMENT TO ITS TERMS AS A CONDITION OF MY PARTICIPATION IN THE COURSE. I FURTHER AFFIRM THAT I AM 18 YEARS OF AGE OR OLDER.

Use your mouse or finger to draw your signature above.

You will receive a web confirmation immediately and an e-mail confirmation shortly.

International SOS

If you are traveling domestically or internationally, creating a profile with International SOS is required as part of the registration process.

Winter Study Travel Courses

For students registered for a Winter Study Travel course:

  • Create a profile with your mobile phone number, Williams email address (unix), and personal email address.
  • Download the mobile application on your phone.

All Other Winter Study Courses

For students traveling internationally OR domestically:

  • Create a profile with your mobile phone number, Williams email address (unix), and personal email address.
  • Create a trip itinerary.
  • Download the mobile application on your phone.
If you are traveling, have you registered with International SOS?*

Emergency Contact Information

Primary Emergency Contact

Please provide at least one reliable way to get in touch with this person.

Secondary Emergency Contact

Please provide at least one reliable way to get in touch with this person.

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