CATALINA 2007 PERMISSION SLIP

INDIVIDUAL GENERAL RELEASE
APPROVAL OF PARENT, LEGAL GUARDIAN, OR CONSERVATOR
(NON-UNIVERSITY SPONSORED OFF-CAMPUS ACTIVITY)

In executing this Release, I certify and understand that this Activity is a non-University sponsored trip, and that California State University, Los Angeles does not require nor condone the Participant's individual involvement in the Activity. The responsibility for supervision, participation, and safety of the Participant is solely the responsibility of the parent/guardian/conservator who is signing this Release.

Trip Counselors will be provided at a ratio to Trip Participants of approximately 1:4 and will be supervising the participants to ensure, to the best of their ability, safety and well-being. Trip Counselors are legal adults and have volunteered their time in service to the Releases.

This document (the "Approval") is executed by (Adult Parent/Guardian/Conservator):

(PRINT ADULT NAME):


In executing this Approval, I certify that I am the (check one): ___Parent ___Legal Guardian ___Conservator of:

(PRINT CHILD'S NAME):
 (the "Participant")

1. I have fully read the contents of this "Individual General Release (Non-University Sponsored Off-Campus Activity)" form (the "Release") on behalf of the Participant, which identifies the "Activity" of:
Camping Trip to Santa Catalina Island
I am aware that this activity will occur on the date(s) of September 6th, 2007 to September 9th, 2007 at the following location(s):
Long Beach to Santa Catalina Island, Hermit Gulch Campground and City of Avalon/surrounding areas

2. In consideration of being permitted to participate in the Activity, I do release, waive, and forever discharge the State of California, the California State University, the Board of Trustees of the California State University, California State University Los Angeles, and the officers, agents, and employees of each of them) collectively, the "Releases"), from and against liability for any harm, injury. loss, damage, claim, demand, action, cause of action, cost, fee, and/or expense of any nature accrued by Participant, regardless of cause, arising or as a result of my participation in the Activity.

3. Having informed myself of the time, place, and nature of the above-described Activity and the waivers and releases contained in the Release, I hereby give my consent to the participation in the Activity by the Participant. In giving this consent I agree to all f the terms contained in the Release and agree to be fully bound by the terms thereof, in consideration for the inclusion of the Participant in that Activity.

4. I understand that Releases may not have medical personnel available during the Activity. I grant permission to the Releases to authorize emergency medical treatment for/to the Participant(s) et al, if necessary.


                   Signature                       Date Signed                  Witness Signature               


RETURN THIS PERMISSION SLIP TO THE EEP OFFICE ONLY