{"id":7452,"date":"2026-07-31T15:01:29","date_gmt":"2026-07-31T19:01:29","guid":{"rendered":"https:\/\/carleton.ca\/icslac\/?page_id=7452"},"modified":"2026-08-10T17:48:43","modified_gmt":"2026-08-10T21:48:43","slug":"student-declaration-of-understanding-and-agreement","status":"publish","type":"page","link":"https:\/\/carleton.ca\/icslac\/student-declaration-of-understanding-and-agreement\/","title":{"rendered":"Student Declaration of Understanding and Agreement"},"content":{"rendered":"\n<section class=\"w-screen px-6 cu-section cu-section--white ml-offset-center md:px-8 lg:px-14\">\n    <div class=\"space-y-6 cu-max-w-child-5xl  md:space-y-10 cu-prose-first-last\">\n\n            <div class=\"cu-textmedia flex flex-col lg:flex-row mx-auto gap-6 md:gap-10 my-6 md:my-12 first:mt-0 max-w-5xl\">\n        <div class=\"justify-start cu-textmedia-content cu-prose-first-last\" style=\"flex: 0 0 100%;\">\n            <header class=\"font-light prose-xl cu-pageheader md:prose-2xl cu-component-updated cu-prose-first-last\">\n                                    <h1 class=\"cu-prose-first-last font-semibold !mt-2 mb-4 md:mb-6 relative after:absolute after:h-px after:bottom-0 after:bg-cu-red after:left-px text-3xl md:text-4xl lg:text-5xl lg:leading-[3.5rem] pb-5 after:w-10 text-cu-black-700 not-prose\">\n                        Student Declaration of Understanding and Agreement\n                    <\/h1>\n                \n                                \n                            <\/header>\n\n                    <\/div>\n\n            <\/div>\n\n    <\/div>\n<\/section>\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_27' ><style>#gform_wrapper_27[data-form-index=\"0\"].gform-theme{--gf-color-primary: #e91c24;--gf-color-primary-rgb: 233, 28, 36;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #B70000;--gf-color-primary-lighter: #FF4E56;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(204, 204, 204, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #e91c24;--gf-color-in-ctrl-primary-rgb: 233, 28, 36;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #B70000;--gf-color-in-ctrl-primary-lighter: #FF4E56;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(204, 204, 204, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 16px;--gf-font-size-tertiary: 14px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-lg-secondary);--gf-ctrl-border-color: #cccccc;--gf-ctrl-size: var(--gf-ctrl-size-lg);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-lg);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-lg);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-lg);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-lg);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-lg);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-lg);--gf-ctrl-btn-border-color-secondary: #cccccc;--gf-ctrl-btn-bg-color-hover-tertiary: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Student Declaration of Understanding and Agreement<\/h2>\n                            <p class='gform_description'><b>Workplace Safety and Insurance Board or Private Insurance Coverage For Students on Program-Related Unpaid Placements<\/b><br><br><b>Student coverage while on unpaid placement:  <u><b>Note: Prior to the start of the unpaid placement,<\/b><\/u> this Agreement must be completed AND submitted online by the student to indicate the Student Trainee\u2019s acceptance of the unpaid work placement conditions.<br><br>The Ontario Ministry of Colleges and Universities provides Workplace Safety and Insurance Board (WSIB) coverage for Student Trainees enrolled in an approved program at Carleton University and participating in unpaid work placements with employers who have WSIB coverage.<br><br>\r\n\u2022 The Ministry provides private insurance for Student Trainees and limited coverage for placements outside of Ontario (international or other Canadian jurisdictions).<br><br>\r\n\u2022 Carleton University has also arranged for private insurance coverage for students who attend placement opportunities that are not covered under either the WSIB or the Ministry\u2019s private insurance.<br><br>\r\n\u2022 Students are advised to maintain insurance for extended health care benefits through the CUSA\/GSA Student Health &#038; Dental Plan or other group or private personal insurance plan. (http:\/\/carleton.ca\/health\/insurance\/)<br><br>\r\n<b>Please be advised that in the event of a workplace injury or disease where a claim is being made,Carleton University will be required to disclose personal information relating to the unpaid work placement and any WSIB claim or claim made through the Ministry\u2019s private insurer.<br><br><\/b><\/p>\n                        <\/div><form class='not-prose' method='post' enctype='multipart\/form-data'  id='gform_27'  action='\/icslac\/wp-json\/wp\/v2\/pages\/7452' data-formid='27' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_27' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_27_38\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_38'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='ginput_container'><input name='input_38' id='input_27_38' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_27_38'>This field is for validation purposes and should be left unchanged.<\/div><\/div><fieldset id=\"field_27_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Student Name and Carleton Student number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name has_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_27_1'>\n                            \n                            <span id='input_27_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_27_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_27_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_27_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_27_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_27_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_27_1_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.8' id='input_27_1_8' value=''   aria-required='false'     \/>\n                                                    <label for='input_27_1_8' class='gform-field-label gform-field-label--type-sub '>Student Number<\/label>\n                                                <\/span>\n                        <\/div><\/fieldset><div id=\"field_27_37\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_37'><span class='gform-field-label__text'>Carleton email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_37' id='input_27_37' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_27_35\" class=\"gfield gfield--type-name gfield--input-type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name of Parent\/Legal Guardian (for students less than 18 years of age)<\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_27_35'>\n                            \n                            <span id='input_27_35_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_35.3' id='input_27_35_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_27_35_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_27_35_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_35.6' id='input_27_35_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_27_35_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_27_33\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Visa Student<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_27_33'><div class='gchoice gchoice_27_33_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.1' type='checkbox'  value='YES'  id='choice_27_33_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_33_1' id='label_27_33_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_27_33_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.2' type='checkbox'  value='NO'  id='choice_27_33_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_33_2' id='label_27_33_2' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_27_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_4'><span class='gform-field-label__text'>Organization&#039;s Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_27_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_27_34\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Estimated Number of Placement Hours<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_27_34'><div class='gchoice gchoice_27_34_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.1' type='checkbox'  value='144 as requirement for either CURA 5011 or CURA 5012'  id='choice_27_34_1'   aria-describedby=\"gfield_description_27_34\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_27_34_1' id='label_27_34_1' class='gform-field-label gform-field-label--type-inline'>144 as requirement for either CURA 5011 or CURA 5012<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_27_34_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.2' type='checkbox'  value='288 hours as requirement for both CURA 5011 and CURA 5012'  id='choice_27_34_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_27_34_2' id='label_27_34_2' class='gform-field-label gform-field-label--type-inline'>288 hours as requirement for both CURA 5011 and CURA 5012<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_27_34'>This placement applies to Graduate students registered in the Graduate Diploma in Curatorial Studies (Institute for Comparative Studies in Literature, Art and Culture, Carleton University) as part of their practicum course requirements. Please indicate whether the estimated number of hours covers a single course (either CURA 5011 or CURA 5012) or both (CURA 5011 and CURA 5012, taken consecutively over two academic terms).<\/div><\/fieldset><fieldset id=\"field_27_25\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Declaration and Agreement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_25.1' id='input_27_25_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_27_25\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_27_25_1' ><span class='gform-field-label__text'>I agree to the following (in lieu of signature)<\/span><\/label><input type='hidden' name='input_25.2' value='I agree to the following (in lieu of signature)' class='gform_hidden' \/><input type='hidden' name='input_25.3' value='31' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_27_25'><div class='gfield_consent_description_text' tabindex='0'>I hereby declare that I have read and understand that WSIB or private insurance coverage will be provided through the Ministry or by Carleton University while I am on an unpaid placement.<br \/>\n<br \/>\nI agree that, over the course of my placement, I will participate in, comply with all safety-related training and procedures provided by the Placement Employer.<br \/>\n<br \/>\nI agree that I will promptly inform my Placement Employer of any safety concerns. If these concerns are not resolved, I will contact my Departmental Co-ordinator at Carleton University and notify them of any unresolved safety concerns.<br \/>\n<br \/>\nI agree and understand that all workplace accidents sustained while participating in an unpaid work placement must be immediately reported to the Placement Employer and department of Risk and Insurance at Carleton University at Risk@Carleton.ca<br \/>\n<br \/>\nI also agree and understand that a Ministry Post-Secondary Student Unpaid Work Placement Insurance Claim form (https:\/\/www.forms.ssb.gov.on.ca\/mbs\/ssb\/forms\/ssbforms.nsf\/FormDetail?OpenForm&#038;ACT=RDR&#038;TAB=PROFILE&#038;SRCH=&#038;ENV=WWE&#038;TIT=1352&#038;NO=022-13-1352E) must be completed and signed in the event of any workplace injury and submitted to the department of Risk and Insurance at Carleton University at Risk@Carleton.ca<br \/>\n<br \/>\nIn the event of an injury, I also agree to maintain regular contact with the department of Risk and Insurance at Carleton University at Risk@Carleton.ca and the departmental co-ordinator to provide all information relating to any restrictions and my ability to return to the placement.<br \/>\n<br \/>\nI understand the implications and consequences of consenting to this this agreement.<\/div><\/div><\/fieldset><div id=\"field_27_36\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_27_36'><span class='gform-field-label__text'>Date<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_27_36'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_36'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_27_36' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_27_36' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_27_36' aria-label='Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <div class=\"gf-turnstile-container\"> <div id=\"cf-turnstile-gf-27\" class=\"cf-turnstile\" data-sitekey=\"0x4AAAAAAEBGc8WPyKQfO_8b\" data-theme=\"\" data-language=\"auto\" data-size=\"\" data-retry=\"auto\" data-retry-interval=\"1000\" data-refresh-expired=\"auto\" data-refresh-timeout=\"auto\" data-action=\"gravity-form-27\" data-callback=\"turnstileGravityCallback\" data-appearance=\"always\"><\/div> <script data-cfasync=\"false\">(window.cfturnstileQueue=window.cfturnstileQueue||[]).push(\"-gf-27\");if(window.cfturnstileRender)window.cfturnstileRender();<\/script> <br class=\"cf-turnstile-br cf-turnstile-br-gf-27\"> <style>#cf-turnstile-gf-27 { margin-left: -15px; }<\/style> <\/div> <style> .gf-turnstile-container { width: 100%; } .gform_footer.top_label { display: flex; flex-wrap: wrap; } <\/style> <script>document.addEventListener(\"DOMContentLoaded\", function() {document.addEventListener('gform\/post_render', function handlePostRender(event) {if (event.detail.formId !== 27) {return;}gform.utils.addAsyncFilter('gform\/submission\/pre_submission', async function handlePreSubmission(data) {document.addEventListener('gform\/post_render', function rerenderTurnstile(event) {if (event.detail.formId !== 27) {return;}const turnstileElement = document.getElementById('cf-turnstile-gf-27');if (turnstileElement) {turnstile.remove('#cf-turnstile-gf-27');turnstile.render('#cf-turnstile-gf-27', (typeof window.cfturnstileOpts === \"function\" ? window.cfturnstileOpts(turnstileElement) : {}));}document.removeEventListener('gform\/post_render', rerenderTurnstile);});gform.utils.removeFilter('gform\/submission\/pre_submission', handlePreSubmission);return data;});document.removeEventListener('gform\/post_render', handlePostRender);});});<\/script><button type='submit' id='gform_submit_button_27' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> <button type='button'  id='gform_save_27_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_27' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_27' id='gform_theme_27' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_27' id='gform_style_settings_27' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_27' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='27' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_27' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_27' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='Nb1WUUgNZNMwF25JYZ4iA0rYLsaXr95bCGGvIk2jl6IOXR\/+lQY9bc7UqCfKivu5H1tnL9x33Qr0YJIMifU0kbT4xGRmTSA98wo57pW01UZL3\/U=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_27' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_27' id='gform_target_page_number_27' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_27' id='gform_source_page_number_27' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":7,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_cu_dining_location_slug":"","footnotes":"","_links_to":"","_links_to_target":""},"cu_page_type":[],"class_list":["post-7452","page","type-page","status-publish","hentry"],"acf":{"cu_post_thumbnail":""},"_links":{"self":[{"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/pages\/7452","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/comments?post=7452"}],"version-history":[{"count":3,"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/pages\/7452\/revisions"}],"predecessor-version":[{"id":7465,"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/pages\/7452\/revisions\/7465"}],"wp:attachment":[{"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/media?parent=7452"}],"wp:term":[{"taxonomy":"cu_page_type","embeddable":true,"href":"https:\/\/carleton.ca\/icslac\/wp-json\/wp\/v2\/cu_page_type?post=7452"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}