Cobb County School District "Blanket" Permission To Participate Form/medical History Permission And Release Form/etc.

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Local Trips
Cobb County School District
“Blanket” Permission to Participate
(Walton High School Habitat for Humanity
Community Fundraisers and Field Trips)
CONSENT
I hereby consent for ____________________________________________ (student’s name) to participate in
Habitat for Humanity community fundraisers and field trips. I understand that transportation may or may not
be provided by the Cobb County School District. In the event transportation is not provided by Cobb County
School District, transportation will be the student’s responsibility.
Detailed information should be given in writing to the parents at least two (2) weeks prior to each trip in the
series.
If any emergency medical procedures or treatment are required by the student during the trip, I consent to
the trip supervisor(s) taking, arranging for, and consenting to the procedures or treatment in his/her
discretion.
WAIVER AND RELEASE
I release and waive, and further agree to indemnify, hold harmless or reimburse the Cobb County Schools
District, the Board of Education, its successors and assigns, its members, agents, employees, and
representatives thereof, as well as trip supervisors, from and against, any claim which I, any other parent or
guardian, any sibling, the student, or any other person, firm or corporation may have or claim to have, known
or unknown, directly or indirectly, from any losses, damages or injuries arising out of, during or in connection
with the student’s participation in the activity, any trip associated with the activity or the rendering of
emergency medical procedures or treatment, if any.
Signature of Parent(s)/Guardian(s)
____________________________________
____________________________________
Date:
________________________
Telephone:
____________________________________
Form IFCB-5

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