I, the undersigned, am the parent or legal guardian of the above named student (“Student”). I have the full power and authority to complete this Permission Form to give consent for the Student to participate in the off-site activity described above. No additional permission or approval from any other person or entity is required.
Voluntary Participation and Waiver of Claims: I acknowledge that the Student’s participation in the off-site activity described above is voluntary and not required by La Salle College Preparatory (the “School”) or any teacher, employee, agent, or representative of the School. I understand that while the School has determined that participation in this activity has educational value, it has not investigated nor approved its safety, the background or qualifications of any person or entity involved, nor the facilities or equipment to be used, including transportation.
I understand that participation in any off-site activity involves risks, including risks of personal injury, property loss, property damage, or death. I acknowledge that these risks cannot be entirely anticipated nor eliminated, regardless of the precautions taken. I voluntarily and knowingly assume all such risks, and hereby waive, release, and discharge the School, and its officers, employees, agents, and representatives, from any and all liabilities for any accident, injury, illness, death, property loss, or property damage that arises from the Student’s participation in this activity, including transportation, even if due to the common negligence of the School or its employees or agents. This assumption of risk, waiver, and release is binding on my heirs and assigns.
Indemnification: I agree to protect, defend, and hold the School, and its officers, employees, agents, and representatives, harmless from any and all claims, demands, liabilities, losses, damages, costs, and expenses (including reasonable attorneys' fees and costs) that arise from the Student's participation in the off-site activity described above.
Authorization to Treat: I am the emergency point-of-contact for the Student in connection with the off-site activity described above. I am to be reached at the listed phone number.
If a medical event arises that concerns the Student, and I cannot be reached at the above phone number for whatever reason, I authorize the School, and its officers, employees, agents, and representatives, to obtain any and all medical services that it deems appropriate for the Student, including arrangements for the Student to receive medical treatment, hospital care, and related transportation. I authorize any licensed health care provider to provide such care and treatment. I consent to any x-ray, examination, anesthetic, medical, surgical, or dental procedure or service deemed necessary by the licensed health care provider. I understand that I am responsible for all costs and fees incurred as a result of the foregoing.
Parent/Guardian Acknowledgement: I have carefully reviewed this document and understand its contents. By my signature below, I hereby agree to all of the terms and conditions stated above and allow the Student to participate in the off-site activity described above.