Field Trip Parental Consent And Release From Liability Form printable pdf download

MELROSE RECREATION DEPARTMENT

Field Trip

Parental Consent and Release from Liability Form

Participation in this field trip is voluntary, but you must give permission before you or your child can go.

Your field trip leader may provide additional details such as clothing requirements, lunch provisions, and

other details in an accompanying correspondence to you. Please read this information carefully. You or

your child will be supervised by recreation staff, teachers, coaches, instructors, and/or parent chaperones.

It is possible that you or your child may face more risks by participating in this field trip than if you or

your child stayed at home. We cannot enumerate every risk, but we believe that you are generally familiar

with this activity and you or your child, and are in the best position to decide whether you or your child

should participate. The Melrose Park Commission and Recreation Manager have approved this field trip,

but we cannot and do not guarantee that there will be no injuries or damages as a result of this field trip.

This is a legal document and you are free to obtain a lawyer’s advice before signing it. You may not,

however, change the language of this form, and any additions or deletions you make to this permission

and release have no effect.

_______________________________________________________________________

By signing this form, we/I, the participant or undersigned parent(s)/guardian(s)

of____________________________________, a minor, do hereby consent to participation in a voluntary

field trip to ______________________________ from (dates) _____________ to _____________ and do

forever RELEASE, acquit, discharge, and covenant to hold harmless and not to sue the City of Melrose,

the Melrose Park Commission and their successors, departments, officers, employees, representatives and

agents, including all field trip volunteers and chaperones, from any and all actions, causes of action,

claims, demands, damages, loss of services, costs, attorneys’ fees, expenses and compensation on account

of, or in any way growing out of, directly and indirectly, all known and unknown personal injuries or

property damage that we/I may now or hereafter have as a participant or parent(s)/guardian(s) of said

minor, and also all claims or right of action for damages that said minor has or hereafter may acquire,

either before or after he/she has reached his/her majority resulting or to result from his/her participation in

this field trip.

Furthermore, we/I hereby agree to INDEMNIFY, hold harmless, protect, reimburse and make good to the

City of Melrose, the Melrose Park Commission and their successors, departments, officers, employees,

representatives and agents from any and all actions, causes of action, claims, demands, damages, loss of

services, costs, attorneys’ fees, expenses and compensation arising from said minor’s intentional, grossly

negligent or reckless acts or omissions while participating in said field trip.

_________________________________________

Participant or Parent/Guardian Name (Please print)

(Parent/Guardian required if under 18 years of age)

_________________________________________

______________

Participant or Parent/Guardian Signature

Date

(Parent/Guardian required if under 18 years of age)

(COMPLETE REVERSE SIDE)

________________________

______________________

___________

Participant’s Last Name

First Name

Middle Initial

Field Trip Parental Consent And Release From Liability Form

Related Articles

Related forms

Related Categories