This is a legally binding release made by participant. The tenn “Undersigned” is used in this agreement to refer only to the program participant. Program participants must be 18 years of age or older.

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    *Full name of Student:

    *I am 18 years of age or older:

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    l. This study abroad program with the Centro de Estudios Hispánicos de Segovia, Spain, henceforth CEHS, has an academic component, and involves living with a host family in Segovia, unless alternative housing arrangements are requested. Group excursions and social/cultural activities are routinely offered to participants. Some trips will be overnight, and most will involve transportation by bus and/or train. The Undersigned fully understands that there are certain dangers, hazards and risks inherent in international travel, program excursions, and in the activities included in the Study Abroad program and have signed this document in full recognition and appreciation of the dangers of these activities, which dangers include, but are not limited to, physical injuries (minimal, serious, catastrophic) and/or property loss or damage; the Undersigned expressly acknowledges that the participant is not required to participate in this Study Abroad program, but chooses to do so.
    The Undersigned therefore agrees to assume and take on all responsibilities in any activities associated with the study abroad program offered by the CEHS, Spain. In consideration of, and in return for, the service, facilities and other assistance provided to participants by the CEHS we release CEHS of any liability, claims and actions that may arise from injury, harm, or death to the Undersigned and from loss or damage to the undersigned’s property in connection with these activities. The Undersigned understands that this release covers liability, claims, and actions caused entirely or in part by any acts or failure to act of the CEHS, and its director, Richard D’Augusta, including but not limited to negligence, mistake, or failure to supervise by the host institution.

    2. I unconditionally release CEHS, and its director, Richard D’Augusta, from any claims for damage, injury, loss. or expense of any nature resulting from events beyond its control, including without limitation, acts of God, force majeure, acts of government, war, strikes, crime, terrorism, sickness or quarantine, health pandemic, government restrictions or regulations. This release also applies to any losses arising from the use of any vehicle or from the selection of, or from any act or omission by, any of the program’s service providers: host family, bus or car rental agency, steamship, airline, railroad, taxi or tour service, hotel service, hotel restaurant, school, university or other firm, agency, company or individual.

    3. I understand that I am responsible for exercising caution and common sense at all times to avoid injuries, and that CEHS cannot provide supervision or support during periods of independent travel.

    4. I agree that if I become ill or incapacitated, CEHS may take such actions as it considers necessary under the circumstances, including securing medical treatment for me and transporting me to the United States. I release CEHS from any liability relating to this medical care. I also authorize CEHS to take whatever action it deems necessary and in my best interest (including transporting me out of the host country or back to the United States, at my own, or my parents’ expense) in the event of political unrest or any other unforeseen event or condition. If CEHS incurs any expense on my behalf that is not covered by insurance, I (and my parents) agree to make immediate repayment upon my return.

    5. I will comply with CEHS rules, standards, and instructions, and understand that failure to do so may result in being sent home at my (or my parents’) expense, with no refund. I understand that my participation may be terminated if I am expelled from the study abroad program or otherwise disciplined by civil authorities, or if CEHS, at its sole discretion, determines that my conduct is incompatible with the interests, harmony, comfort, or welfare of other students studying in the CEHS program. I (and my parents) agree to indemnify CEHS if I do anything that causes CEHS to sustain financial loss or liability.

    6. CEHS independent program participants (an “independent” participant is defined as a student that is not participating as a registered member of an American university’s customized program with CEHS) are covered under a comprehensive premium CISI (Cultural Insurance Services International) health plan for the duration of the program (semester, short-term), but not in their home country. Coverage provided by this policy is meant to supplement private insurance and to provide certain coverage for activities related to traveling abroad. I understand that detailed information on the coverage of this policy has been made available to me. I understand that health care and evacuations outside my home country are not covered by most standard insurance policies and can be extremely expensive. I am solely responsible for payment of all non-covered medical evacuation, trip cancellation, trip interruption, baggage loss/damage, accident/sickness and all other insurance expenses incurred by me during my program or related to my program.
    I understand that real or perceived epidemics and/or pandemics (such as, but not limited to, Covid-19, Ebola, SARS, etc.) can delay, disrupt, interrupt, or cancel programs. I agree to assume all risk of any loss or problems which could result from any such occurrences, including but not limited to the cancellation, disruption, delay, transition, or other alteration of my program.

    7. I understand that future promotional and publicity materials of CEHS may include statements made by participants or their photographs, and I consent to such use of my comments or photographs of me. CEHS reserves the right to use and/or disseminate documents and materials including any social media posts created by the Participant(s) whole on the program. I grant CEHS the right to use these records in perpetuity for promotional and any other commercial purposes without any cost, limitation or restriction including, without limitation, the payment of any fee.

    8. I understand that CEHS reserves the right, in its sole discretion, to make changes in the program itinerary, changes in the order of activities, and other modifications including but not limited to, changes in courses, activities, group travel package, and other program elements as listed in program promotional materials. All such changes are without liability on the part of CEHS for any monetary loss I may incur as aresult.

    9. I understand that obtaining a passport, student visa, and/or any other required travel documents is my sole responsibility.

    10. If I am not a citizen of the United States, I understand and accept that it is my responsibility to obtain all visas and required documents because of my not being a United States citizen in order to enter all the countries on my itinerary and participate in the study abroad program of CEHS. Further, (whether I am a U.S. citizen or not) I shall not hold CEHS responsible in the event I am unable to obtain the necessary documents for participation in the program. I understand that the inability to obtain these visas and other documents does not constitute grounds for withdrawal with refund.

    11. CEHS retains the right, in its sole discretion, to contact my home or program school, as well as my parent (host and natural) and/or guardian, regarding health or safety issues, account balances, or any other matter whatsoever which relates to me or my program. These rights transcend all privacy regulations that may otherwise apply. I hereby waive my rights under the Family Educational Rights and Privacy Act.

    12. This agreement will be effective when my application is accepted by CEHS, and shall be governed by the laws of Spain.

    13. This agreement cannot be modified except in writing by CEHS.

    14. I agree that any dispute with CEHS that is not settled informally and amicably, will be submitted to the Courts and Tribunals of Segovia for final judgement.

    Students are asked to sign the application agreeing that this will comprise the agreement between the Centro de Estudios Hispánicos de Segovia (CEHS) and the student applicant after he or she is accepted into the program.
    I the undersigned, an applicant for a Study Abroad Program offered at the Centro de Estudios Hispánicos de Segovia, acknowledge that I have read and accept the terms and conditions set forth. This agreement is a legally binding contract.
    By signing this agreement, I understand that I am giving up my right to have any claim against the Centro de Estudios Hispánicos de Segovia decided in Court before a judge or jury.

    *Applicant’s signature / name:


    By including my name and date I hereby certify that all the information I have provided on this application form are correct.

    In accordance with the established Organic Law 15/1999 for the Protection of Personal Data, the information collected in this document is included in an automated processing file belonging to Richard Crescenzo D’Augusta (Tax I.D. # X2676498B), trade name (CEHS), in compliance with the security measures required by law, for the purposes that are clear from this document; the user reserves the right to access, rectification, erasure or objection by means of a written petition, together with a copy of a valid I.D. card, to the following address: C/San Valentín, 12, Entresuelo A, 40003, Segovia, España.