Columbia College | Columbia Engineering

Home / Columbia Outdoor Orientation Program (COOP) Participant Consent Form / Columbia Outdoor Orientation Program (COOP) Participant Consent Form

Warning message

Submissions for this form are closed.

Columbia Outdoor Orientation Program (COOP) Participant Consent Form

I understand that the goals of Columbia Outdoor Orientation Program (COOP) are to provide a positive experience in a supportive group environment. I am aware that as a participant I am required to follow the policies and guidelines set by COOP and instructions from the Outdoor Orientation Leaders. As part of Columbia University, COOP adheres to the University standards of respect for others. COOP is a substance-free program- alcohol or drugs of any kind are prohibited. Any violation of the substance policy may result in judiciary action.

I hereby certify that I am aware that specific personal apparel and equipment is necessary for my participation in this program and that it is my obligation to provide this equipment. I acknowledge that my failure to provide the necessary apparel and equipment may prevent my full participation in this trip. I also understand that I am responsible for and must return any COOP equipment that I borrow for this trip. I understand there may be a specified fee associated with participating in this trip and that I am responsible for paying that fee. I hereby grant permission for any photos or videos that are taken during this activity to be used by Columbia University in promotional or other material.

I acknowledge that my participation in this trip is voluntary. This trip is not within the course and scope of my studies at Columbia University and is for my personal enrichment and recreational benefit. I am aware that my participation in this trip involves activities in remote locations with limited access to hospital medical care. I am aware of the potential hazards of this activity, including, but not limited to, animal and insect bites and stings, gastro-intestinal infections from water, infections, heat or cold-related illnesses, falls, inclement weather, lightning, and difficult trail and road conditions. There are risks of travel as well, including risks associated with motor vehicles and poor driving conditions.

I believe that I have been fully and adequately briefed regarding the risks inherent in the trip. I have weighed the dangers inherent in this trip, the risks presented to my own health and well-being, and my personal desire to participate in this trip. I have concluded that the risks are acceptable and are outweighed by my desire to participate.

In consideration of Columbia University enabling me to participate in this Outdoor Orientation program, I voluntarily assume all risks associated therewith. I hereby waive, release, and agree to hold harmless Columbia University and the Columbia Outdoor Orientation Program including, without limitation, Trustees, employees, agents, students and/or representatives from any and all claims that I may have as a result of personal injury, including death, or property damage or loss arising out of or connected in any way with my participation in this program, accepting only such damages and costs resulting from the gross negligence of Columbia University, the Columbia Outdoor Orientation Program, the Trustees, employees, agents and/or representatives. This release includes claims arising out of the rendering of emergency medical procedures or treatment, if any.

I hereby give my consent to Columbia University and thereby to leaders in the Columbia Outdoor Orientation Program to render medical treatment should it be required during this trip. In the event that a parent or guardian cannot be reached, I hereby give permission for transport to and treatment at a hospital facility. If I am taking medications or have a disability, I agree Columbia University may share this information with the COOP leaders for my personal benefit. I hereby confirm that I am 18 years or older. This Release/Agreement shall be binding upon the Participant and my heirs, administrator, executors and assigns. I agree that any mediation, suit, or other proceeding must be filed or entered into only in the state of New York.

Undergraduate Student Life

Visit

505-515 Alfred Lerner Hall
2920 Broadway
New York, NY 10027

Call: 212-854-3612

Office Hours
MondayFriday
9:00 a.m.5:00 p.m.