PARENTAL WAIVER FORM (Athletics)

This Waiver Agreement is to be used by all schools for such cases as short trips by school teams, clubs and other functions held
off the school premises. This form will be used a blanket permission slip to cover a variety of school-based activities this year.
This will save parents from signing permissions slips for every small activity their children participate in. *Note: There may be
separate permissions slips for special activities.

TO PARENTS
1. Parents not clear on the nature of the function concerned should contact the school before signing this form.

2. In the event of a curricular activity, an alternate replacement curricular activity will be offered for those students
whose parents do not consent to the Parental Waiver Form.

3. The student will only be permitted to travel to and from the destination by the means of transportation
designated by the administration and indicated below.

Nature of Activities:
This permission slip will cover all sporting events (Soccer, Volleyball, Handball, Basketball,
Rugby & Track and Field) for our students participating in extra-curricular activities. We will
be traveling during the school day to throughout the year to the other elementary school in
the district (Diamondvale, Nicola Canford, Colletville, Bench and Vermillion Forks
Elementary).

Date of Activity: September 2014 – June 2015

Means of Transportation: We will be using a variety of transportation means from school buses to parent vehicles, to
bicycles to walking as a group.

Method of Supervision: Students will be supervised by teachers, SEAs and approved parent/community volunteers.

Location of Activity: District Elementary Schools (Diamondvale, Nicola Canford, Colletville, Bench and Vermillion
Forks Elementary).

NAME OF STUDENT (please print): ______________________________________________________

I hereby give my permission for my child to take part in the activity as outlined above, and hereby agree to well and
sufficiently indemnify and save harmless the School Board and keep the School Board indemnified and harmless of any and
all demands, actions, proceedings, liability claims, damages, together with the costs and expenses thereof, that may hereafter
at any time be made or brought by or on behalf of my child for any injury, loss, damage, expense and costs sustained or alleged
to have been sustained by my child howsoever arising from the aforesaid activity provided.

SIGNATURE OF PARENT/GUARDIAN:_________________________________________________

D A T E S I G N E D : _________________________________________________________________