Walmart Shuttle Sign Up
The Campus Shuttle leaves from the Lincoln Hall Parking Lot at 2:00 p.m. on the scheduled Sunday.  Students are expected to arrive early to check in to allow the shuttle to leave in a timely manner. The driver will designate a meeting place at Walmart upon arriving in the shopping center parking lot. The shuttle will depart from Walmart for campus no later than 3:40 p.m. Students who are not aware of their time run the risk of missing the shuttle ride back to campus, at their own risk.  Additional stops cannot be authorized by the driver on the day of travel.
Students who sign up for the shuttle, and then cannot make it on Sunday are expected to notify Shelby Carey at shelby.carey@ic.edu (or text 217.320.5558 the day of) that they will not be traveling with the shuttle.
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Email *
Please enter your FIRST and LAST name: *
Student identification (ID) number: *
This is the 8-digit number on the front of your ID card, underneath your name
EMERGENCY CONTACT: Please list the name of your emergency contact person (CANNOT BE SOMEONE RIDING THE SAME SHUTTLE) *
Ex. Firstname Lastname
Please select the Sunday that you are interested in taking the Campus Shuttle to Walmart (Submit a separate response for each shuttle you plan to take): *
Please enter a phone number that you can be reached at *
Ex. (555) 555-5555
EMERGENCY CONTACT: Please list your emergency contact persons phone number: *
Ex. (555) 555-5555
EMERGENCY CONTACT: Please list your emergency contact persons relation to you: *
Please read the statement below and check that you understand: *
Required
IC Rides Waiver and Release Policy Statement
I intend to participate in the IC Rides program (“Program”) approved by Illinois College (“College”). In consideration for being permitted to participate in the Program, the receipt and sufficiency of which is hereby acknowledged, I agree and represent as follows:
1) I understand that the College reserves the right to establish rules for participation in the Program, and I will comply with those rules. The College, in its sole discretion, may terminate my participation in the Program if I violate the rules or behave in a manner which is disruptive or which could impede or obstruct the progress of the Program in any way, or affect adversely the reputation of the Program or the College. I understand that, if my participation in the Program is terminated, I will receive no academic credit nor receive a refund of any Program fees.

2) I understand that, although the Program in which I will participate makes every reasonable effort to assure my safety while participating in the Program, I hereby acknowledge my awareness that my participation in the Program may expose me to risk of property damage and bodily or personal injury, including death. I understand that the risks I may encounter include motor vehicle accidents and other travel-related accidents; cuts, bruises, broken bones, sickness, other injuries and health-related occurrences; criminal acts and/or terrorism, as well as other risks that may not be foreseeable. I have investigated the risks, and I hereby assume any and all such risks, and I release and promise not to sue Illinois College or its trustees, officers, employees, agents, successors and assigns.

3) For the sole consideration of the College arranging for my participation in the Program, I, individually, and on behalf of my heirs, successors, assigns and personal representatives, hereby release and forever discharge the College and its governing board of trustees, their members individually, and their officers, age  ts and employees (in their official and individual capacities) from any and all claims, demands, rights and causes of action of whatever kind, arising from or by reason of any personal injury, property damage, or the consequences thereof, resulting from or in any way connected with my participation in the Program and/or any travel incident thereto, including any acts of negligence on the part of the College, its trustees, officers, employees or agents.

4) I have or will secure comprehensive health and accident insurance to provide adequate coverage for any injuries or illnesses that I may sustain or experience while participating in the Program. By my signature below, I certify that I have confirmed that my health care coverage will adequately cover me while I participate in the Program, and I hereby release the College, and its employees and agents, from any responsibility or liability for expenses incurred by me for injuries or illnesses (including death) that I may incur because of those injuries or illnesses, including medical bills, charges and similar expenses.

5) I authorize any representative of the College to secure dental and medical treatment for me if I am injured or become ill while participating in the Program, including without limitation anesthetic and surgical treatment, and further authorize any representative of the College to sign authorization forms necessary to obtain the treatment. Neither the College nor its employees and agents shall be responsible or liable for any expenses or damages I may incur as a result of the College acting pursuant to this grant of authority.

6) I, individually, and on behalf of my heirs, successors, assigns and personal representatives, agree to indemnify, defend and hold harmless the College, and its trustees, officers, employees, agents, successors and assigns (in their official and individual capacities), from any and all liability, loss, damage, claim, suit and cost which arises out of, occurs during, or is in any way connected with my participation in the Program or any travel incident thereto, including claims and suits arising out of any of my alleged acts or omissions, and any claim or suit made on my behalf by my legal representatives, heirs, successors and assigns.

7) I agree that, should any provision or aspect of this agreement be found to be unenforceable, all remaining provisions of the agreement will remain in full force and effect.

8) I represent that my agreement to the provisions herein is wholly voluntary, and further understand that, prior to signing this agreement, I have the right to consult with the advisor, counselor or attorney of my choice.

9) I agree that, should there be any dispute concerning my participation in the Program that would require the adjudication of a court of law, such adjudication will occur in the courts of, and be determined by the laws of, the State of Illinois. Unless the College agrees otherwise, venue shall be in Morgan County, Illinois.

This agreement represents my complete understanding with the College concerning the College’s responsibility and liability for my participation in the Program, supersedes any previous or contemporaneous understandings I may have had with the College on this subject, whether written or oral, and cannot be changed or amended in any way without my written concurrence.
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