Due Date: First Day of Class

The Allied Health Program Activity Participation Waiver Release of Liability releases College of the Canyons from any liability if you are injured, become ill, or die as a result of class-related activities. It is required for all healthcare courses. Please read it carefully before signing.

Step 1

Use a computer, not a phone or tablet
- Students can access computers for free at the Valencia TLC and Library and the Canyon Country Library and Learning Center in the Student Services Building.
- Students who have paid the Student Support Fee can print documents for free (worth up to $16/month ) through the Wepa app.

Download the form and save it to the computer's desktop
Open the saved file from the desktop
Type your information in the boxes on BOTH pages
- Page 1
  - Participant Name: Type in your LAST NAME, FIRST NAME
  - COC Student ID: Type in your COC Student ID
  - Use the dropdown to select the semester you are taking the course (this will not work unless you have downloaded and saved the form and then opened the saved form)
- Page 2
  - Name: Type in the name of your emergency contact
  - Telephone: Type in the cell phone number of your emergency contact
  - Signature of participant: You may digitally sign this, or you can sign it by hand after you print it
  - Date of Signature: Type in today's date
  - Print name of participant: Type your LAST NAME, FIRST NAME

Step 2

Print the form and use a paperclip to attach it to Checklist 1 in the order shown on the checklist. Do NOT use staples.