uGroups

Visit Registration - Personalized DRAFT

Date Information - Personalized

Your requested visit is during what section of our open dates: *

Date of Visit: *

Your visit request must be during a date listed in the above question. Personalized visits are available Monday-Thursday, 8:30a-5:30p and Friday, 8:30a-12:00p. A typical personalized visit lasts approximately 4 hours. We are not able to accommodate visit meetings or tours on Friday afternoon, Saturday or Sunday. If none of the open dates work for you, please call us before submitting a request. 402.486.2504

What type of personalized visit would you like? *

Day visit

Overnight Visit

Date of Arrival *

Date of Departure: *

Does AM or PM work better for you? *

AM (approximately 8:30a-1:00p)

PM (approximately 1:00p-5:30p)

Both work for me

Student Information - Personalized

Student First Name: *

Student Last Name: *

Gender: *

Female

Male

Mailing Address: *

City: *

State: *

Zip Code *

Student Email Address: *

We will be communicating your schedule, lodging, and transportation information via email so please provide an email you check regularly.

Confirm Student Email Address: *

We will be communicating your schedule, lodging, and transportation information via email so please provide an email you check regularly.

Student Cell Phone: *

Guest Information - Personalized

I will be visiting Union... *

by myself.

with 1 parent or sponsor.

with 2 or more parents or sponsors

If you are attending with other prospective Union students, please do not list them here. Each student will need to individually register.

Attending Parent or Sponsor's name: *

Attending Parent or Sponsor's cell phone: *

Attending Parent or Sponsor's email: *

Please list all attending additional guests other than the parent/sponsor listed above. *

Please include guests' first and last name and their relation to the attending student.

Do you or your guests have food allergies or dietary needs we should be aware of:

I.E. Vegan, lactose intolerant, gluten free. Please note Union Market only serves vegetarian meals.

Emergency Contact - Personalized

Are you 19 years old or older? *

Yes

Name of Emergency Contact: *

Emergency Contact phone number: *

Waiver/Release Information under 19

I understand and agree that I am responsible for arranging my child's own health, accident, and liability insurance, and that no such insurance is provided by Union College.

I hereby authorize the employees and/or agents of Union College, at their sole discretion, to secure such medical advice and/or services as may be deemed necessary for my child's health and safety, and I agree to accept full financial responsibility for such advice or services.

Release and indemnification: On my behalf and on behalf of my child, and each of my and my child's heirs, executors, and administrators, and in exchange for and in consideration of Union College permitting my child to participate in this campus visit and related activities, I hereby assume all the risks of injury associated with this campus visit and related activities and agree to release, hold harmless, and indemnify Union College, their affiliates, and their respective officers, directors, employees, agents, successors, and assigns, and each of them (collectively the "releaseesÔÇØ) from any and all liability, actions, causes of action, negligence, claims or demands of any nature whatsoever that may arise by or in connection with my participation in this campus visit and related activities.

In signing this release, I acknowledge and represent that I have read the foregoing Waiver of Liability and Hold Harmless Agrees, understand it, and sign it voluntarily by my own free act and deed; and that i am at least nineteen (19) years of age and fully competent to execute this agreement.

Signature of Parent/Legal Guardian here: *

Date here: *

Waiver/Release Information 19+

I understand and agree that I am responsible for arranging my own health, accident, and liability insurance, and that no such insurance is provided by Union College.

I hereby authorize the employees and/or agents of Union College, at their sole discretion, to secure such medical advice and/or services as may be deemed necessary for my health and safety, and I agree to accept full financial responsibility for such advice or services.

Release and indemnification: For myself and all those who may claim through me or in my place, and in exchange for and in consideration of Union College permitting me to participate in this campus visit and related activities, I hereby assume all the risks of injury associated with this campus visit and related activities and agree to release, hold harmless, and indemnify Union College, their affiliates, and their respective officers, directors, employees, agents, successors, and assigns, and each of them (collectively the "releaseesÔÇØ) from any and all liability, actions, causes of action, negligence, claims or demands of any nature whatsoever that may arise by or in connection with my participation in this campus visit and related activities.

In signing this release, I acknowledge and represent that I have read the foregoing Waiver of Liability and Hold Harmless Agrees, understand it, and sign it voluntarily by my own free act and deed; and that i am at least nineteen (19) years of age and fully competent to execute this agreement.

Sign here: *