General Waiver Form
General Waiver Form
Please complete this form to ensure a safe and informed participation experience for all students and families involved in school activities.
Participant Information
Name
Date of Birth
Please enter your date of birth in the format MM-DD-YYYY.
Emergency Contact Name
Phone Number
Provide a phone number where we can reach you.
Activity/Program Details
Activity Name
Date of Activity
Location
Organizer/Company Name
General Waiver & Release of Liability
I, the undersigned participant or legal guardian of the participant named above, hereby acknowledge the following:
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Acknowledgment of Risk: I understand that participation in the activity/event may involve inherent risks, including but not limited to injury, accidents, or illness.
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Release of Liability: I, for myself and on behalf of my child/ward, release, discharge, and hold harmless the organizer, its employees, agents, and representatives from any and all claims, damages, or liabilities arising out of or related to my child’s participation in the activity/event, whether caused by negligence or otherwise.
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Medical Treatment Authorization: In the event of an emergency, I authorize the organizer to seek medical treatment for my child/ward and agree to be responsible for all costs incurred.
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Insurance: I confirm that my child/ward has adequate health insurance to cover any medical expenses incurred while participating in this activity/event.
Name:
Date:
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