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Permission Slip for Travel and participation 

for RYA Spring Break Trip 2023

Participants/Parents/ Legal Guardians CONSENT AND RELEASE FORM


I understand that my (or my child’s) participation in the activity is a privilege, and not a right. I acknowledge that I have spoken with my child about my child’s need to comply with the specific rules and requirements established for this activity; all state and federal regulations and laws. I also understand that private drivers, will be used to transport volunteers to and from the activity. The owner of the vehicle must carry bodily injury insurance. Reptile Youth Alliance insurance and The C.A.R.E foundation’s insurance does not cover damages arising from, or related to, the operation of any private vehicle, failure to follow the directed driving route, or any personal negligence related to this activity. Any damages/harm resulting from a parent/guardian/or other designated driver arising from the operation of a motor vehicle in relation to the above listed activity, is hereby waived.

I also understand that I have the ability to refuse to sign this Form. In addition, that if I refuse to sign, my child will not be permitted to participate in the activity.I also understand that this trip may expose myself or my child to some risks and I assume any such risk that may arise there from. I accept full responsibility for all medical expenses for any injuries that might occur to my child by reason of his/her participation.

By signing this form, however, I hereby release Reptile Youth Alliance, the C.A.R.E Foundation, its Board, its Board members, employees, directors, employees, agents, assigns, and volunteers (“released parties”) from and against any and all claims, demands, actions, complaints, suits or other forms of liability that any of them may sustain (a) arising out of my child’s failure to comply with local, state, and federal laws and District policies, and Reptile Youth Alliance procedures, (b) arising out of any damage or injury caused by my child; or, (c) arising out of a parent/guardian/or other volunteer in relation to this activity. I also agree to indemnify and hold harmless the released parties from the released claims, including any and all related costs, attorney fees, liabilities, settlements, and/or judgments.

Participant's Name

Email Address*

Address*

Phone*

In case of emergency, Please contact: *

Dietary Restrictions*

Medication*

Signature*

by Checking this box, I confirm that I have carefully read this CONSENT AND RELEASE and agree to its terms knowingly and voluntarily*

My Child will need a ride to the CARE Foundation*

Select an option
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