Waiver Of Liability (Page 2 of 2) in pdf

Waiver Of Liability Page 2

STATEMENT OF STUDENT RESPONSIBILITY

This form is necessary for any student staying overnight at Mount Holyoke College. Please complete this

form, along with the Waiver of Liability. You may fax both to the Office of Admission at (413) 538-2409,

or bring the forms with you on the day of your visit.

We are very pleased that you plan to stay overnight at Mount Holyoke College. This is an excellent opportunity

for you to explore daily life at the College. We ask that all overnight visitors agree to the following statements:

1) While on campus, I will be held to the same standards and code of conduct as an enrolled student

and I will assume sole responsibility for my own actions.

2) I am aware that although Mount Holyoke College has agreed to host me overnight, neither the

Office of Admission nor any other office or personnel of Mount Holyoke College will be

supervising me at all times during my stay on campus.

3) I am aware that participants in on-campus visitation programs are required to abide by

Massachusetts state law, and I agree to do so. I acknowledge that Massachusetts’ law prohibits all

use of illegal drugs and prohibits the drinking of alcoholic beverage by persons under 21 years of

age.

Signature of Student (required)

Date

Signature of Parent/Guardian (required)

Date

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Waiver Of Liability Page 2