Department of Athletics
(714) 278-3058 / Fax (714) 278-5396	ATHLETICS TRAVEL WAIVER/RELEASE

California State University, Fullerton
Department Of Intercollegiate Athletics
Student-Athlete Travel Waiver/Release

I, the undersigned student-athlete, waive any and all legal rights I may have or accrue against California State University, Fullerton, and release said institution from any liability arising from the athletic trip described below.  Further, I certify that I will be going only to and from the event and I assume the risk of traveling to and from that event site and any and all risks inherent to the trip whether as a driver or a passenger.

I agree to indemnify California State University, Fullerton, its employees, agents and officers and hold it and them harmless from liability for my acts, and shall defend the institution, its employees, agents and officers from all actions for damages wherein it is alleged that liability exists solely by reason of my tortuous acts.

STUDENT-ATHLETE INFORMATION: (please print)

NAME			SSN		

SPORT			

EVENT DATES(s)			EVENT SITE		

  I AM A PASSENGER	DRIVER’S NAME		

  I AM THE DRIVER
PASSENGER’S NAMES		

If you are the driver, please complete all of the following:

DRIVER’S LICENSE #			EXP. DATE		

AUTO INSURANCE COMPANY			POLICY #		

Signatures:

	Student-Athlete			Date	

					
	Head Coach			Date