Statesboro STEAM Field Trip Waiver / Permission Form
I, the undersigned parent of the participant, am requesting participation in
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School:
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Statesboro STEAM Academy
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Activity:
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Pooler Theater (Zootopia)
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Teacher:
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Statesboro STEAM Academy Faculty/Staff and Designees
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Mode of Transportation (e.g. state/personal vehicle, airplane):
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Teachers/Chaperones
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That begins on
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Dec. 2
at
11:00 AM
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and ends on
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Dec. 2
at
3:30 PM
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all of which are hereinafter referred to as the activity.
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In consideration of my participation or my child’s participation in the activity, I hereby waive all claims or causes of action against Statesboro STEAM Academy and the officers, directors, employees, and agents, arising out of my participation or my child’s participation in the activity and hereby release, hold harmless, and discharge Statesboro STEAM Academy from all liability in connection therewith.
Knowing, understanding, and fully appreciating all possible risks including exposure to or contracting Covid-19, I hereby expressly, voluntarily, and willingly assume all risks and dangers associated with my participation or my child’s participation in this activity. Some of the risks and dangers are listed below. I understand this list is not exhaustive. Common risks include: Travel to and from home and activity meeting location, overnight stay, food poisoning, theft, car accident, pedestrian accident, tripping, slipping, falling, etc.
I have read this waiver/release and understand the terms used in it and their legal significance. This waiver and release is freely and voluntarily given with the understanding that the right to legal recourse against Statesboro STEAM Academy is, knowingly, given up in return for allowing participation in the activity. My signature on this document is intended to bind not only myself but also my successors, heirs, representatives, administrators, and assignees.
