Request edit access
Ninja Warrior Waiver/Reminder
When: Friday, October 13th, 2:30 - 7:00 (see appropriate times for grade level)
Who: Grades 3rd - 8th (2nd grade to participate during school)
Approximate Times: (3rd & 4th- 2:00-3:30) (5th & 6th - 3:30-5:30) ( 7th & 8th - 5:30 - 7:30)
Where: South End of Football Field
What: Fundraiser to support local causes, community-based needs, and the P.E. Department
Email address
This agreement releases Staunton School District # 6 from all liability relating to injuries that may occur (during activity, on location, etc.). By signing this agreement, I agree to hold SCUSD# 6 entirely free from any liability, including financial responsibility for injuries incurred,regardless of whether injuries are caused by negligence. I also acknowledge the risks involved in obstacle courses. These include but are not limited to bruising, muscle pulls, sprains, fractures, etc. I am participating voluntarily, and that all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity.
Please contact Mr. Kolesar if you would like a paper copy of this waiver.
Grade of Student
Last Name of Student
Your answer
First Name of Student
Your answer
By signing this electronic agreement I fully understand and agree to the above terms and permit my child to participate in the Staunton Ninja Warrior Fundraiser
Parent Signature
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Never submit passwords through Google Forms.
This form was created inside of Staunton CUSD #6. Report Abuse - Terms of Service - Additional Terms