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RULES AND REQUIREMENTS. I agree to conduct myself in accordance with BREVARD - page 1 / 4

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NON-EMPLOYEE INTERNATIONAL TRAVEL

RELEASE OF LIABILITY, WAIVER OF RIGHTS,

ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

I, ____________________________ (“Participant”), hereby acknowledge that I have voluntarily elected to participate on the Geology and Ecosystems of the Galápagos Islands, Ecuador Field Trip to be held in and around Galápagos Islands from June 8-17, 2011. In consideration for being permitted by BREVARD COLLEGE to participate in the Program, I hereby acknowledge and agree to the following:

ELECTIVE PARTICIPATION. I acknowledge that my participation is elective and voluntary and is not required by BREVARD COLLEGE. As a condition of my participation, I hereby grant BREVARD COLLEGE the right to use, for promotional purposes only, any photographs of me taken by BREVARD COLLEGE its employees or agents, during my participation in the Program. I further understand and agree that BREVARD COLLEGE may use (for marketing purposes) any statements or quotes attributed to me in my evaluation of the Program.

RULES AND REQUIREMENTS. I agree to conduct myself in accordance with BREVARD COLLEGE policies and procedures. I further agree to abide by all the rules and requirements of the Program. I acknowledge that BREVARD COLLEGE has the right to terminate my participation in the Program if it is determined that my conduct is detrimental to the best interests of the group, my conduct violates any rule of the Program, or for any other reason in BREVARD COLLEGE 's discretion. I understand that in the event my participation in the Program is terminated for violating any rule of the Program, I will be solely responsible for the cost of return travel. I further understand and agree that BREVARD COLLEGE is not responsible for any injury or damage that I sustain if I travel independently or am otherwise separated or absent from BREVARD COLLEGE sponsored activities. I acknowledge that I am solely responsible for any legal problems I encounter with any foreign nationals or government and BREVARD COLLEGE is not responsible for providing any assistance under those circumstances.

INFORMED CONSENT. I have been informed of and I understand the various aspects of the Program, including but not limited to the fact that the Program will be held in and around Ecuador. I understand that travel outside the United States is considered dangerous and I accept the risks of such travel. I have received and reviewed the travel itinerary for the Program and understand the risks involved in traveling, to, within and from Ecuador and the Galápagos Islands, including but not limited to foreign political, legal, social, and economic conditions, language barriers, safety hazards, crime, disease, consumption of food, civil unrest or hostilities, terrorism, war, natural disasters and weather conditions, and negligent first aid operations or medical treatment. I further understand that serious injuries could occur during my participation in the Program and that as a Participant I could sustain personal injuries, property damage, or even death as a consequence of participation in activities, local transportation to and from Ecuador and nearby areas, international travel to and from Ecuador.

I understand and hereby acknowledge that I have carefully reviewed and fully understand the directives and recommendations, including recommendations concerning immunizations and medicines (hereinafter “recommended immunizations”) for travel to, in and around Ecuador, provided by:

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