Internship Registration form

INTERNSHIP TERMS AND CONDITIONS

Concordia University, St Paul itself does not control the way in which this educational opportunity is structured or operates on a daily basis. In granting credit for this internship/practicum experience, the University affirms that to the best of its knowledge the experience is an appropriate curricular option for students seeking work-related experience but makes no other assurances, expressed or implied about any travel, wages, or living arrangements made by the student and employer.

Concordia University does not knowingly approve internship or practicum opportunities which pose undue risk to their participants. However, any program or travel carries with it potential hazards which are beyond the control of the Lutheran Church-Missouri Synod, Concordia University, its Board of Regents, officers, and its agents or employees.

INSURANCE COVERAGE

• I have health, accident and hospitalization insurance to cover me during my internship; I further understand that I am responsible for the costs of such insurance and for any expenses not covered by the insurance and I recognize that Concordia University does not have an obligation to provide me with such insurance. The activities of this agreement do not create an employer-employee relationship in any manner and I will not be entitled to any form of workers’ compensation benefits.
• I assume full responsibility for any undisclosed physical or emotional problems that might impair my ability to complete the experience and I forever release Concordia University from any liability whatsoever for injury to myself or damage to or loss of my possessions.
• I understand that if I use my personal vehicle for the benefit of the organization with whom I perform my internship/practicum, Concordia University has no liability for personal injury or property damage which may result from that use. I agree to rely solely on my personal vehicle insurance coverage and on any insurance which may be provided by my internship site. In addition, I shall not seek reimbursement for any non-covered expenses or policy deductibles that I may incur as a result of using my personal vehicle for the activities stated herein this agreement.
• I understand that I will not be entitled to unemployment compensation benefits upon completion of my internship. Further, I understand that Concordia University assumes no liability for personal injury that I may suffer in the course of my internship and I agree to be responsible for ascertaining whether my internship site provides workers compensation coverage for me.

PERSONAL CONDUCT
• I understand that the responsibilities and circumstances of an off-campus internship or practicum may require a standard of professional decorum that may differ from that of Concordia University. Therefore, I indicate my willingness to understand and conform to the professional standards of the internship site. I further understand that it is important to the success of the present internship/practicum and the continuances of future experiences that interns observe standards of conduct that would not compromise Concordia University in the eyes of individuals and organizations with which it has dealings.
• I acknowledge the responsibility of Concordia University and the Internship Supervisor to set rules and interpret conduct for this purpose. I agree that should Concordia University or the Internship Supervisor decide that I must be terminated from my experience because of conduct that might bring the program into disrepute or the internship site into jeopardy, that decision will be final and may result in loss of academic credit.

• I understand that if I use my current place of employment as my internship site it is my responsibility to work with my site supervisor to receive timely feedback and ensure I am in compliance with the employer's policies, state and federal laws.

GENERAL RELEASE
• I understand that Concordia University reserves the right to make cancellations, changes or substitutions in cases of emergency or changed conditions or in the general interest of its Internship/Practicum Program at any time.
• It is further expressly agreed that the internship/practicum site and use of any or all of its facilities shall be undertaken by me at my own sole risk and that Concordia University shall not be liable for any and all claims, demands, injuries, damages, actions or causes of actions, whatsoever to me or property arising out of or connected with the experience and with the use of any and all services, or facilitates associated with the internship whether or not sponsored by Concordia University. I release and forever discharge Concordia University, their agents and servants, successors and assigns, directors, trustees, officers, employees, and other representatives from any and all liability, causes of action, claims, or damages arising out of or related to any loss, damage, or injury sustained by any person (including myself) from any and all present or future claims, demands or actions in law or in equity that may hereafter be made or brought by me as a result of this experience.
• Concordia University, St Paul is committed to reasonable accommodations for students with qualified disabilities (including mental health and medical conditions). Any student considering an internship or other experience outside of the traditional classroom who may require accommodations should speak with Student Accessibility Services prior to the commencement of the experience. This is to ensure modifications are implemented in a reasonable time frame.