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Warning Text %XTableStyleMedium9PivotStyleLight16`!q(15) Study Tour Agreement&a(16) Med, Insur, Emerg Contact(17) Code of Conduct  ;#S bV DateID #5Medical, Insurance, and Emergency Contact InformationDates of travel Trip Destination Legal Name Birth date ID NumberSchool address Phone Home address %Parent or guardian (if under age 18)  Relationship Daytime phone Evening phone My doctor Phone number Generic name US trade nameDosage schedule I take the following medications#Blood type and Rh factor (optional){Do you have any limitations that would interfere with the challenges of travel or study in the areas planned for this trip? l Yes l No&Do you already have medical insurance?;(Please attach a photocopy of your medical insurance card.)PCopy goes with Group Leader on trip. Original on file for 3 years in department.ANDREWS UNIVERSITY#Contact person in case of emergencySTUDENT INFORMATIONEMERGENCY CONTACT INFORMATION%Alternate person in case of emergencyMEDICAL INFORMATIONKnown Allergies{If yes, please describe. The Trip Leader will try to accommodate your needs, but they must know your limitations in detail.You must have medical insurance in order to participate. If you do not have insurance, it can be purchased. Ask your Trip Leader.Ƶ University Tour Name Tour Director Tour DatesSponsoring DepartmentI acknowledge and agree that after an airline ticket has been purchased in my name, I will be responsible for bearing the cost of any cancelation or change fees OR the full cost of the ticket if the airfare is not refundable.Signer Email AddressSigner Telephone #I agree to participate in this tour, and I commit to paying this total amount subject to the information provided below, independent of whether I receive academic credit or not. TOTAL COST$Andrews University  Trips and ToursCitizenship Violation: Your signature below will be interpreted as evidence of your commitment to conduct yourself in the manner which is described above. Participant NameTrip Destination(Please PRINT Full Name) Minor Violation: will require a meeting with the trip director where a restriction may be imposed. If necessary, a collect phone call may also be made to your parent(s) or guardian(s).  !Student Code of Conduct AgreementAs representatives of Ƶ University, the Seventh-day Adventist Church and, ultimately, the United States of America, it is our goal to be positive role models representing the mission of Ƶ University. Therefore, all participants, whether they are students, faculty, alumni, parents and other family members, or friends are expected to adhere to the general Ƶ University Community Values outlined in the student handbook as well as those specified in this agreement./Respect: General respect should be demonstrated at all times for other trip participants, trip director(s), as well as the individuals, values, and laws of the culture visited. Verbal and physical abuse, as well as disregard of the directors instructions and these guidelines, will not be tolerated.  , iCurfew: Unless there is a trip or tour sponsored activity that extends past midnight, you should expect to abide by a midnight curfew and be in your hotel room from midnight until the next morning. Also, you should respect other guests by keeping noise to a minimum after 10 pm. The schedule will often begin early so you will want to have a good night's sleep. Sexual Misconduct: You may be sent home at a parent's or guardian's expense for inappropriate sexually related conduct. Members of the opposite sex are not allowed in your living/sleeping quarters at any time or for any reason.  Hotel Guidelines: Be especially respectful with your room and roommate as well as considerate of other hotel guests by refraining from boisterous behavior at all times. You are responsible to ensure that friends or other guests (who are not assigned to your hotel room by the trip director) do not utilize your hotel room. You will be held personally responsible for any damage you cause, and you will not be allowed to leave the hotel until the damage is paid. When a hotel reports damage to a room, we will investigate, but will ultimately consider the hotel s report to be definitive. You will be responsible for phone calls made from your room and any extra hotel expenses. The removal of towels, ashtrays, etc. and other hotel items as souvenirs is forbidden and is considered stealing, since waiters and maids are required to pay for any missing items. Shirts and shoes should be worn anywhere in the hotel outside your room. As a reminder, do not leave your passport, money, or valuables in a place where someone can easy take them.  7Free Time Periods: All trip and tour activities require your attendance and participation. When no organized group activities are scheduled and you leave your hotel you should sign out with the tour leader, giving the time of departure and a description and location of your activity. You should always travel in groups of 2 or more and carry the name and phone number of the hotel with you at all times. You are expected to be mindful of your own safety and well-being at all times. Take caution in whatever you do or wherever you go, especially in unfamiliar areas.[ !Dress: Please be mindful of the Ƶ University dress code ("Ƶ Look") regarding modesty and appropriateness, or as prescribed/dictated by the local culture and customs, as well as other dress guidelines requested by the trip director when choosing clothing to bring on the trip.  Continued Violation: The Office of Student Life will be contacted, and a collect phone call to your parent(s) or guardian(s) will be made. The trip director will determine whether to send the student home at the student's expense.  Participant Signature ________________________________________________ Date ________________________}Alcohol & Drug Use: The use and/or possession of alcohol, tobacco, and illegal drugs is prohibited under ALL circumstances.  i l Weapons: Weapons such as knives, firearms, or firecrackers may not be bought or in the possession of participants. This includes dive knives.  Serious Violation (such as threatening & disrespectful behavior, alcohol and drugs, sexual misconduct, etc.): will result in immediate disciplinary action that will include contacting your parent(s) or guardian(s) and being sent home at your own expense without further warnings. The office of Student Life will be contacted and the student should expect to meet with a student life representative to receive appropriate consequences prior to returning to classes. Name of Faculty/Staff Turkey 2015Dr. Rubn Muoz-LarrondoReligion DepartmentMarch 11-22, 2015Faculty/Staff SignatureI agree to participate in all academic, social, and spiritual activities required prior to the beginning of the tour, and during the tour.Registration Total Cost/incl. Reg_I authorize Ƶ University <uto charge my personal paycheck in the total amount (half of the tour) of _____________ for the paychecks dates of ________________ to ______________. I understand that $200 dollars are not refundable after Dec 10, 2014. Cancellations after Jan 15, 2015 will be insured and processed by Adventist Risk Management policy.QSubsidized Cost for Fac/Staff: $2,490, Spouses: $2,690; Community: $2,990 dbl rm.$300 to save a seatTurkey;Faculty & Staff Professional Development Tour - Turkey 2015RI acknowledge and agree that, by signing this document, I am committing to paying the entire Faculty/Staff Tour cost. If, for any reason, I change my plans and cancel my participation in the tour, I recognize that I will be responsible for up to the entire amount of the tour cost. The University will work to find a suitable replacement or to otherwise minimize and reduce the costs I would need to bear, but I fully accept that I may have to pay up to the full amount of the tour cost if I withdraw from the tour. 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