Student Center and Event Services

Event Liability Waiver Information Form

Event Liability Waiver Information Form

Home Events Event Liability Waiver Information Form

Please be advised

The information provided in this document will be used to address student safety, specific insurance requirements and risk issues.

Therefore, all information must be true, honest and accurate.

See Policies Applying to Campus Activities, Organizations, and Students

The form below is for an SCES event client. The information you provide will be sent to the Student Center & Event Services and Risk Management offices.

If you are not working with SCES on the event, contact Risk Services directly about your waiver needs. SCES will not follow up on submissions from non-SCES clients.

Your Contact Information

Waiver Type

Event Sponsor Details

Organization or individual

Waiver/Program Contact Information

The information provided in this section will be listed on the waiver in case participants and/or parents/guardians have questions about the event and/or its activities.

Event Information

Include start date to end date
Brief statement that focuses of the program goal and activities
Must include a full agenda with times (start and end), locations (e.g., Pacific Ballroom A or Aldrich Park) and activities (lecture, sports activity, lunch, reception, dance, etc.)
Click or drag a file to this area to upload.
File types allowed: .doc, .xls, .ppt, .pdf, .png, .gif, .jpg. Maximum filesize: 8MB.
(e.g., snacks will be provided by event sponsor, participants will be eating in the Residential Dining Commons and/or lunch will be ordered from UCI Catering)

Responsibilities

Overnight Programs

Any false, misleading or intentionally inaccurate information may subject the author, as well as the entire RCO, to disciplinary action and may affect the organization’s reservation privileges. By submitting this form, I attest to the accuracy of the information provided.

A311 Student Center · Irvine, CA 92697-2050
Phone: 949.824.5252 · Email: reserver@uci.edu