International Language Campuses
Liability Waiver & Information for students attending EF Saint-Raphael Please complete this form and return it to your local EF office as soon as possible. This sheet will be given to the Host Family selected for the student or to the Residence staff (as applicable). I, the undersigned, (Mr / Mrs / Miss) Address Daytime telephone: Evening telephone: Acting as parent/guardian of: Taking a language course at EF in Saint-Raphael from
until
Liability Waiver - Declare that the host family selected by the school (or residence staff, if applicable) will not be held responsible for the student while they are away from the host home or school residence, or are not in the presence of the host family. This applies to the duration of the student’s stay. - Understand that the host family selected by the school will impose a curfew (11 p.m. every night for all students). The curfew will automatically be imposed for all students. We won’t accept any exception; every student must follow it despite being accompanied by a member of their family. - Confirm that the student is healthy and fit to participate in the program of study abroad in which he/she is enrolled. - Confirm that all known previously existing medical conditions of a serious nature from which the student has suffered have been declared to staff and a medical report submitted if necessary. - Confirm that information pertaining to any current medications has been provided to the staff, and that the student will be traveling with a supply of any such medications, and/or renewable prescriptions. - Authorize the host family or school staff in the case of an emergency to authorize medical treatments and care if necessary / Je donne mon accord pour que la famille d’accueil ou les membres du personnel EF autorisent des soins médicaux et la prise de medicaments en cas d’urgence. Please send a copy of your ID or passport together with this liability waiver to EF so that your authorization can be taken into account. - Accept that the student can be expelled in the case of unacceptable behavior (as described in the Student Code of Conduct which should accompany this form). - Understand that the student must abide by the laws and regulations of the host country and host EF organization.
Guidelines & information Please list here any instructions you have given to the student that you would like us to know about, and any information which should be passed on to the host family or EF staff (e.g. allowing to miss all activities, thus limiting EF’s responsibility) / instructions à l’attention de la famille d’accueil et/ou de personnel EF (ex: dispense des activités, limitant ainsi la responsabilité de EF):
Please indicate all necessary information concerning the health of the student (allergies, special diets, medications, etc.) A medical report should accompany this form if a serious condition exists, or has existed in the past / informations relatives à la santé de l’étudiant€) allergies, régime special, traitements…)
Signature:
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Please send a copy of your ID or passport together with this liability waiver to EF so that your authorization can be taken into account.