I assume the risks of personal injury and/or property damage in participating in the program listed above at The Catholic University of America. I understand that students will leave CUA campus during this program and that I may travel in a university-owned or private vehicle. I understand that any violation of campus rules may result in termination of my attendance in the program and/or judicial charges.

I will not hold responsible The Catholic University of America for liability for injury or damages arising from the result of my participation in this Program unless it is due to willful fault or gross negligence on the part of The Catholic University of America.

I hereby give permission for me to receive medical treatment, if necessary, while attending the program.

To the best of my knowledge, there are no physical or other conditions that will interfere with my participation. I am at least 18 years old, and I enter this agreement voluntarily.