- Waiver Form Matrix
- McGrath Health & Wellness Center Waiver
- BIKE XU Long Term Rental Agreement and Waiver
- BIKE XU Short Term Rental Agreement and Waiver
- Service Alternative to Documentation Fines Program
These waivers are the only forms approved by Xavier University and may not be modified or changed in any way.
Please read this entire page before you use the waivers posted on this site for the first time.
The waiver form matrix contains a link to access a pdf form for each of the various waivers. The instructions will help you determine which waiver form is appropriate to your activity or event.
The following information is provided to assist you step-by-step with:
- Determining whether you need "waivers" for your specific activity or for your group;
- Helping you select the proper paperwork, if you need waivers; and
- Explaining how to prepare and use the paperwork that you need.
- Retention of forms.
Using documents and information provided on this site does not give you permission for your particular trip or activity. That permission must come from the appropriate University department or office before you may use these forms.
Please review all of the information provided on this page to answer any questions you might have. If you are still unable to determine what you should do, please contact Mary Beth Townsley as soon as possible before you need your waivers so she may have ample time to assist you.
Mary Beth Townsley
Coordinator, Risk Management and Insurance Programs
Xavier University (513) 745-2090 | E-mail
Do I need "waivers" for my specific activity or group?
"Waivers" is the general term used here to refer to a collection of documents which often must be signed prior to individuals participating in certain experiences both on- and off- campus. Xavier students, Xavier faculty and employees, as well as non-Xavier individuals may need to sign waivers before participating in an activity. If you are unsure whether waivers are necessary for your group or activity, please consider the following:
- Waivers are required for all University-sponsored or affiliated off-campus trips where the trip is expected to consist of five or more off-campus overnight stays and for any international travel for any length of time.
- If a University-sponsored or affiliated off-campus trip or activity is not expected to consist of five or more off-campus overnight stays, waivers are only required if the trip or activity is expected to involve unusual risks or the activity or the trip tends to be more risky than everyday on-campus activities.
- Waivers should be completed by anyone participating in any one-time on-campus activity that includes unusual risks or that tends to be more risky than everyday on-campus activities.
- If waivers are required for a particular trip or activity and non-Xavier individuals are participating as part of the Xavier group, those individuals should also execute the proper documents.
In the case of off-campus activities or trips not expected to consist of five or more off-campus overnight stays and any on-campus activity, determining whether waivers are required involves considering what potential risks are involved in the activity. Please use these examples to help you make a reasoned judgment about whether your particular event or activity involves unusual risks or tends to be more risky than everyday on-campus activities.
- Activities where injuries may easily occur, such as --
- Rock climbing, repelling, downhill skiing, snow boarding, whitewater rafting, horseback riding, dodge ball, bungee jumping, skydiving.
- A high ropes course.
- Doing service that includes climbing on ladders or being up on a roof.
- A student organization hosting a mud wrestling competition.
- Participating on a sports team that involves travel to other schools and competition against students from other schools.
- An R.A. and a group of students going out to dinner in Cincinnati.
- Xavier students taking buses to the Labor Day Fireworks.
- A flag or touch football game between Xavier students, on the Xavier campus.
- Going to Kings Island for the day.
- Hosting a college bowl competition on campus for Xavier and Non-Xavier students.
- A weekend retreat to Higher Ground.
- On-campus carnival- or festival-type games, rides and activities.
Note: These are only examples to help you to make a judgment about your own activity. Please read the rest of the information contained here if you need additional guidance.
Remember that members of clubs, club sports teams, groups and academic classes may sign the appropriate forms to cover all of that group's activities for an entire academic year.
How do I know which forms to use?
Once you determine that you need waivers (see above) for your particular experience, the chart below will help you determine which forms suit your purpose. It is arranged so that you can consider certain aspects of your particular event or organization and then find the forms under the appropriate headings. Below is a description of the headings used in the chart that will enable you to decide which category best suits your needs.
Type of Participant
The individual signing the form will determine which forms are needed. There are different forms for:
- Xavier Students: an individual becomes a Xavier student on August 15th before the start of the fall semester for students who begin in a Fall Semester. For all other students, becoming a Xavier student is on the date that the student must certify that he or she has health insurance.
- Xavier Faculty Members or Employees: in most instances, faculty members and employees will be participating in an experience as part of their employment, as a representative of Xavier even if the experience does not normally relate to the faculty member or employee's role at Xavier. For instance, an employee who is asked to go on an Alternative Break trip with students is acting within the scope of his or her employment because there is a University purpose for that employee's participation, namely, to act as a Xavier representative on that trip. When a faculty member or employee is acting within the scope of his or her employment, he or she is not required to sign an Assumption of Risk (AOR), but must still sign any other appropriate forms for that type of experience. However, if a Xavier faculty member or employee is not acting within the scope of his or her employment (e.g., an employee decides he or she would like to go on an Alternative Break Trip, but the University already has sufficient faculty or employee representatives going, and his or her participation is for purely personal reasons), he or she must sign the AOR, in addition to any other appropriate forms for that type of experience. Situations where faculty members and employees are acting outside the scope of their employment will be relatively rare and, therefore, the AOR form will rarely need to be completed by faculty members or employees.
- Non-Xavier Individuals: This category includes all non-Xavier individuals, including students, faculty and employees from other schools, partners, family members and friends of Xavier individuals, and any other individuals who are not students, faculty members or employees of Xavier.
If your participants will be from more than one status, you will need forms for each status represented in your group.
Type of Experience
There are two basic categories of forms for Xavier students and Xavier faculty members and employees-those that apply to one-time experiences and those that apply to ongoing activities of a particular group. One-time experiences are broken down into forms for on- and off-campus activities. Ongoing experiences forms depend on the type of ongoing experience. To help determine which is appropriate for your situation, please consider the following:
- One-time experience: One-time experiences are any event, activity or trip that is a single experience. For example, an Alternative Break trip is a one-time experience, as is a weekend ski trip or a single event that occurs on campus. One-time experiences may last multiple consecutive days, but would not include weekend ski trips that occur two weekends in a row.
- On-campus: Activities occur on campus every day. These forms are only used for risky activities, as described above.
- Off-campus: Off-campus experience forms are separated into forms for day trips and overnight trips:
- Day trips: Use these forms if your experience does not require an overnight stay away from campus, or if the experience lasts less than 24 hours even if an overnight stay. For example, you can use this form if vans are leaving from campus in the evening for overnight skiing and returning the next morning.
- Overnight trips: Use the appropriate forms based on whether the trip is a domestic (within the United States) trip or an international trip, and whether a Xavier faculty member or employee is participating in the trip on behalf of Xavier or whether it is a student led trip. Note that you will need to contact Mary Beth Townsley if you are planning an international trip.
- Ongoing experiences: Ongoing experiences are those where an activity repeats throughout the academic year (such as an internship where a student goes to an off-campus location on a regular basis throughout a semester) or where there are different types of activities conducted through a particular group. The appropriate forms depend on the type of experience:
- Internship: These forms are to be used for all off-campus internships or co-op experiences. Use Form 107a for general internship experiences. Form 107b is specifically for student professional field experiences.
- Clubs, club sports teams, groups, academic classes: These forms are to be used by clubs, club sports teams, groups and academic classes whose members plan to or may participate in multiple experiences of the same or varying nature with that particular group throughout an academic year. For example, if a student activity club expects to have multiple activities throughout the academic year that will require waivers under this policy, the members of that group can, at any time, complete the appropriate forms, which will then apply to any activities from that point forward. Those forms will then apply to all activities which that student participates in with that student activity club for the remainder of the academic year, avoiding the hassle of completing forms for each individual activity throughout the year. Note: These forms will not apply to trips that are expected to include five or more overnight, off-campus stays. One-time forms will need to be completed and notarized for such trips, even if the students have already executed this ongoing experience form.
- Ongoing on- and off-campus activities: A faculty member or employee may execute these forms to cover any on- or off-campus activities that he or she may participate in throughout an academic year, regardless of whether the activities are associated with different groups of students.
For Non-Xavier individuals, please determine whether the experience is on-campus, off-campus, or includes a combination of both and use the appropriate form.
What to do once you know which forms you need
Once you determine the category that best suits the particular experience and status of the participants, click on the link which will open all of the forms that you need. You will need to print and execute all the pages contained in the link. Click for the Waiver Matrix.
Important information regarding use of these forms
Please note the following information:
- Blanks on the form should be completed as indicated by you and/or by the individual participants. After printing off the appropriate form, you may want to write in the general information that will apply to all participants (e.g., the name and date of the experience) before you copy and distribute the forms to each participant to execute.
- The experience or trip organizer should ensure that each participant signs the appropriate form(s) and collect the completed forms prior to the start of the experience.
- If you have read the material on this page and are still unsure of whether or not you need a waiver, please contact Mary Beth Townsley. If Mary Beth is unavailable and your activity is about to begin, please err on the side of caution and use the waiver that you believe is most appropriate for your type of activity.
- The only University-approved forms are those posted to this site. All university-approved forms are marked as such. If an outside organization has supplied an alternate form for your activity or group, you must consult with Mary Beth Townsley.
- No one is permitted to alter the content of these forms without specific approval.
- Using documents and information provided on this site does not give you permission for your particular trip or activity. That permission must come from the appropriate University department or office before you may use these forms.
Which forms must be notarized?
The forms provide instruction when a notary must sign. The only forms that will require a notary are the AOR and Release forms. Specifically, a notary must sign the following:
- The AOR and Release for any off-campus domestic trip that is expected to include five or more overnight, off-campus stays.
- The AOR and Release for any international trip for any length of time.
Many offices on campus have a notary.
What should I do with the completed signed forms? Retention of forms:
- Event organizer or group leader or individual traveling alone should carry all original signed forms during the experience or trip. If a student is traveling alone, the student must carry the original signed forms. In a medical emergency, only the original signed medical release is acceptable; a copy will not suffice.
- The sponsoring office or department should keep one paper or electronic copy of all completed signed forms available during the experience or trip. You are encouraged to print forms using both sides of the paper (print double sided).
- Because an individual who is hurt while participating in such a trip or experience will likely only have two years to bring any legal claims, one paper or electronic copy of all forms should be retained by the office sponsoring the trip or experience for a period of two years after the conclusion of the trip or experience. The stored copy of the signed completed forms may be a scanned electronic copy, a paper copy, or the signed original forms.
- Campus Police should be given one paper or electronic copy of the signed medical form before the experience or trip begins for off-campus experiences consisting of less than five days.
- For overnight experiences expected to consist of five or more off-campus overnight stays, Campus Police should be given one paper or electronic copy of all completed signed forms before the experience or trip begins.
- Campus Police will discard their copy after the experience or trip concludes.