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CONSENT, RELEASE & INDEMNITY FORM

STUDENT PARTICIPATION IN A SCHOOL-SPONSORED TRIP

GRAPEVINE –COLLEYVILLE INDEPENDENT SCHOOL DISTRICT

Recognizing that it is an educational benefit for students to participate in field trips and that it is not a requirement of the curriculum, parents/guardians are required to provide this signed consent and release form for their child to attend the below described field trip.

Name of Field Trip: UIL One Act Play                         Day & Date of Field Trip: Feb-May 2022

Brief Itinerary:

Mode of Transportation:                        Origination Point: GHS                Destination Point: Various

                         

Termination Point:  GHS                Time of Departure: TBA         Time of Return:  

Number of Students:  

Number of Adult Supervisors: 3

Cost Per Student:                 

I, ______________________________ (parent/guardian) am the parent and/or legal guardian of ___________________________ (student). I hereby give my consent for _______________ (student) to travel with and participate in ____________________________________________ (name of field trip).  

I, and on behalf of my personal representatives, successors, and assigns, hereby agree to release, indemnify and hold harmless the District, its trustees, employees, and agents from all claims made by third parties against it or them that result from my child’s actions on the trip.

As per Board Policy FMG(LOCAL), students who participate in school-sponsored trips shall be required to ride in transportation provided by the school to and from the event. Exceptions may be made if the student's parent/guardian presents a written request to the principal before the scheduled trip, requesting that the student be allowed to ride with the parent, with another person designated by the parent, or that the student be allowed to drive him or herself to the event. The District shall not be liable for any injuries that occur to students riding in vehicles that the District does not provide.  I, and on behalf of my personal representatives, successors, and assigns, hereby agree to release, indemnify and hold harmless the District, its trustees, employees, and agents from all claims made against it or them that result from my request to use alternate transportation.

I understand that the District, its trustees, employees, and agents are not waiving any sovereign or governmental immunity that it or they have under Texas law.

I have read and understand this information and sign it voluntarily with full knowledge of its significance. I also understand that if I choose for my child not to participate in this field trip that an alternate activity will be provided for my child at the campus.

☐        My child may participate in this activity.         ☐        My child may not participate in this activity.

        _________________________________         __________________________________        ________

                  Student Name (Please print)        (Parent Signature)                                (Date)

        _________________________________        _________

             Student’s Signature (If 18 years old)        (Date)

In case of an emergency, please contact one of the following:

1. ___________________________________________________________________________________

                 Name                                                                                   Phone number with area code

2. ___________________________________________________________________________________

                 Name                                                                                    Phone number with area code

Parents/guardians are encouraged to consult with an attorney to understand their rights and obligations before signing this form.

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