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White Bear Lake Area Schools Parent/Guardian Transportation Waiver
Email *
This agreement is entered into by and between Independent School District No. 624, White Bear Lake Area Public Schools and (Parent/Guardian Name):
WHEREAS, (Student Name) *
is attending (Event) *
located in (Location) *
on (Date) *
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WHEREAS, the Parent/Guardian represents that They have the legal right to make decisions relating to the education and safety of the Student;

WHEREAS, the parent/guardian has requested that their child (describe request)

 *

WHEREAS, the District seeks to comply with the Parent/Guardian wishes regarding the Student’s education and safety;

NOW THEREFORE, IN CONSIDERATION OF being permitted to allow their Student to

 *

the Parent/Guardian hereby releases the District, its officers, agents, and employees, from any liability for damages from illness, injury and/or death that arises out of, or is connected with, or in any manner relates to the release of the “Student” from the District’s supervision on said field trip. The mutual promises and agreements contained in this document, the Parent/Guardian, the Student, and the District hereby agree as follows:

1. The Parent/Guardian and Student are submitting this release, waiver of liability, and assumption of risk declaration voluntarily and their own free will.

2. The Parent/Guardian and Student understand and EXPRESSLY ASSUME all the dangers incident to releasing the Student from District supervision, and hereby RELEASE ALL CLAIMS, including but not limited to, personal injury, property damage or destruction, and death, whether caused by NEGLIGENCE, breach of contract or otherwise, and whether for bodily injury, property damage or loss otherwise, which they may ever have against White Bear Lake Area Public Schools, its officers, agents and employees.

   3. The Parent/Guardian and Student hereby agree that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence and is intended to be broad and inclusive as is permitted by the laws of Minnesota and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

By signing below, each party acknowledges that it has read and fully understands the terms of this Agreement, and that it intends to be legally bound by those terms.

Dated:

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Clicking Submit below is considered your signature.  The form will be emailed to Coach Gittins, Athletics Director Brian Peloquin, and your email address entered above. 
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