Overnight Agreement and Release of Liability

Please read this document thoroughly with your parent/guardian before submission.


All visitors must observe the following guidelines for conduct. 

  1. The student is responsible for her own actions and behavior. She will show respect for property and facilities used during the activity and assume financial responsibility for any damage she causes.
  2. The student is responsible for following all policies outlined in this agreement. If the student breaks or violates a policy, her parent/guardian will be contacted and the student will have to vacate the residence hall/campus facilities. It is the student’s responsibility to inquire if the student is unsure about a policy. In this regard, the student expressly acknowledges that such policies have been provided and explained to the student.
  3. The student will be respectful of the residence hall and classrooms and her roommate’s and other classmates’ property.
  4. The College does not tolerate the possession, use or distribution of alcohol or drugs which are illegal under state or federal law, or any other controlled substance for which the student does not possess a valid prescription from a licensed physician.
  5. Cottey College is a tobacco-free campus. Participants and their visiting guests are not allowed to buy, possess, distribute or use any kind of tobacco product on campus.
  6. It is understood that if the student violates any of the rules while visiting Cottey College and is asked to leave, the student may be denied the opportunity to attend future College programs or functions and she will forfeit any scholarships and program fees associated with the Workshop.
  7. I hereby consent to any publicity, including the use of my name and likeness, in connection with my participation in all activities at Cottey College.



As a overnight visitor, the student will stay in one of the College’s residence halls. Students will not be permitted to participate in an overnight stay without this completed form.

  1. Each student must follow curfew times as well as policies for checking in and out of the building.
  2. Each student acknowledges that she may only spend the night in the residence hall room designated by the College. For the purposes of this policy, this means the student must be in her assigned room between the hours of 11 p.m. and 6 a.m. except for emergencies, to use the bathroom facilities, or with the permission of staff.
  3. Loud noises, yelling, slamming doors, running, or any other activity that is not conducive to a healthy living environment is prohibited in the residence halls and classroom facilities. In this regard, Cottey College reserves the sole discretion to determine what conduct or activity is not conducive to any associated activities.


The student and the student’s parent, guardian, or custodian:

  1. Recognizes that Cottey College is not the insurer of the student’s health or safety, and has no duty to control third parties.
  2. Fully accept and understand that there are potential dangers and risks to which the student may be exposed by participating in an overnight stay at Cottey College.
  3. Agree to assume all of the potential risks and dangers, whether or not foreseeable, in any way associated with the student’s participation in an overnight stay at Cottey College (including without limitation any and all medical expenses incurred resulting from any illness or injury to the participating student) and associated activities.
  4. Release and agree to hold harmless Cottey College (and its board of trustees, officers, employees, students, and agents) from any and all liabilities, claims, and actions that may arise from injury or harm to the student or to any third-party, from the students death or that of any third party proximately caused by the student, or from damage or loss to the student’s or any third-party’s property in connection with Cottey College or associated activities.
  5. Understand that this Agreement and Release means I am giving up, among other things, the right to sue Cottey College, its board of trustees, officers, employees, students and agents for injuries, damages or losses that the student or the student’s parent, guardian or custodian may incur.
Student Agreement and Release of Liability

I hereby declare that I, the student participating in an overnight stay at Cottey College:

  1. Acknowledge that I have read this entire Agreement and Release, that I fully understand it, and that I agree to be legally bound by it.
  2. Agree that this represents the entire agreement and that there are no other oral or written promises or representations which in any way modify its terms.
Parent/Guardian Agreement and Release of Liability

I hereby declare that I am the parent or legal guardian of the named participant and I consent to the participant’s participation in this program. I acknowledge that I have read this entire document, that I fully understand it, and that I agree to be legally bound by it.

In the event of sudden illness, accident, or injury which may occur while my child or ward is engaged in this activity (program), when neither the parents nor guardians can be contacted, I hereby give my consent for emergency medical treatment as necessary under the circumstances to any medical care provider licensed under the laws of the State of Missouri.

Safety Information

Reasonable care will be taken to PROVIDE a safe, protected environment for the visiting student. Neither Cottey College nor its personnel will be liable for any loss, theft or injury incurred.

Enrollment Management
1000 West Austin, Nevada, Missouri 64772
Phone: (417) 667-6010
Fax: (417) 448-1025