The following Waiver is required for Participation.  Without exception, failure to sign will preclude participation.  Permission slip for Participation in After-School Sports sponsored by Portola Valley School District.

I want my daughter/son/legal charge to participate in the Corte Madera After–School Volleyball program.

1. I FULLY UNDERSTAND THAT THIS ACTIVITY CAN BE DANGEROUS and that my daughter/son/legal charge could be injured, even if the activity is conducted with due care by all concerned.

2. I AM FULLY AWARE OF THE RISKS and hazards inherent in my daughter/son/legal charge engaging in this activity and I voluntarily elect, both on my behalf and on behalf of my daughter/son/legal charge to have her/him engage in that activity, that the activity is such that my daughter/son/legal charge may be injured even if the Portola Valley School District and utilize due care. I also know that the Portola Valley School District, is not a guarantor of my daughter/son/legal charge’s safety and financially could not conduct this activity if it bore the risk or injury or death arising out of same. I THEREFORE VOLUNTARILY ASSUME ALL RISKS OF LOSS, DAMAGE, INJURY OR DEATH to my daughter/son/legal charge arising out of her/his participation in this activity.

3. It is my intent by this clause to exempt and to relieve the Portola Valley School District, its officers and agents, from any and all liability for personal injury, wrongful death or property damage arising out of my daughter/son/legal charge involvement in this activity.

4. I further agree to indemnify and hold harmless the Portola Valley School District, its officers, agents, employees, and representatives from and against all death, injuries, damages, whether incurred by judgment or settlement, including legal expense and attorney’s fees, of whatever nature occurring during, by reason of, or arising out of
my daughter/son/legal charge’s participation in said activity, and I shall assume the defense and/or settlement of any claim, suit or action brought against the Portola Valley School District, or its officers, agents, employees or representatives to recover any such damages.

5. Further, on behalf of myself, my daughter/son/legal charge, and our personal representatives, assigns, heirs, and next of kin, I HEREBY RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE the Portola Valley School District, its officers, employees, agents or representatives for loss or damage and any claims or demands therefore on account of injury or death to my daughter/son/legal charge, whether caused by negligence of the Portola Valley School District, or their employees or volunteers, where such injury or death occurs during, by reason of or arising out of this activity.

Upon completion of this registration form, the recommended donation is $175.  Please submit a check to the CMS office.  Please make all checks payable to Portola Valley School District.  Students will not be denied the opportunity to participate should they not be able to pay any or all of the suggested donation.  If outreach assistance is needed, please contact Kate Cox directly at kcox@pvsd.net.