Remembrance Day Walk to Remember

ATTENTION: This is a legal document. Please read carefully the contents of this consent form and clarify any concerns with the staff at the school organizing the event or the School Principal  before completing each section. 

It is important that this form is completed in its entirety, and electronically signed,  in order for your child to participate in this activity.

Waverley Memorial Elementary School  is collecting  the  personal  information requested in this form to: obtain lawful consent for your child to participate in the activity; coordinate the activity; respond and report respecting any injury or medical condition that may arise during, or as a result of the activity; and update School records where necessary. 

The information will only be accessed by authorized School staff and will be dealt with in accordance with the privacy requirements of the Nova Scotia Freedom of Information and Protection of Privacy Act. 

The information will not be disclosed to any other person or agency unless it is for a purpose stated above, the disclosure is authorized or required by law, or you have given the School permission for the information to be disclosed. 

IN CONSIDERATION of Waverley Memorial Elementary School offering my child, an opportunity to participate in the activity described below on November 10th, I hereby give and provide my consent, and acknowledge by my signature that my child may participate.

 We will be walking to the Waverley Legion on November 10th between 10 and 11:00 am to lay wreaths and observe a moment of silence.  Students will be supervised by staff members of WMES.

Please complete this form by Monday, November 6th.

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There are inherent risks, hazards and dangers while participating in walking trips. Some risks include:  effects of weather; existing and changing walking route;  collision with natural and man-made objects and with others; condition of the terrain, environment and facilities;  unmarked obstacles; ability and fitness of students; separation from the group; insect bites, poison plants and wildlife; acts of fellow participants;  injury, paralysis or death

I am aware of the usual risks and danger involved in participation in this activity, including any specified above and of the possibility of personal injury, fatal injury, property damage or loss that may result.



I understand that my child will be supervised by their classroom teacher, as well as other WMES staff members. 



If you checked #2 above please list illness, allergy, or disability:  


Students will need to be dressed accordingly for the weather on the 10th (sneakers/boots that are comfortable for walking, and appropriate outer wear for the weather).

I acknowledge that it is the responsibility of me and my child to ensure that all necessary  clothing is brought by my child to the event and acknowledge that my child may be prevented from participation if s/he does not have all necessary clothing.



My child and I understand that the Regional Code of Conduct applies during this activity. My child and I also understand that site rules and regulations are in place for this activity and my child agrees to abide by these rules and regulations.  I acknowledge that I have explained to my child that any prohibited actions may result in my child not being allowed to participate or continue in the activity.



Accidents can result from the nature of this activity and can occur with or without any fault on either the part of the student, HRCE or its employees or agents, or the facility where the activity is taking place.  By allowing my child to participate in this activity, I accept the risk of an accident and agree that this activity, as described above, is suitable for my child.



I understand that if I am not comfortable with my child participating in this activity that arrangements will be made for my child to remain at the School during School hours and my child will not be penalized for non-participation.



Should the School need to contact me during this event:

Contact Number Valid for the Time of the Activity:  

Alternate contact information if necessary: *


In signing this Consent, I am not relying on any oral or written representation or statement(s) made by the Regional Centre, its servants, agents, employees, or authorized volunteers to induce me to allow my child’s participation in this activity other than those contained in this Consent. 

Student's First Name: *
Student's Last Name: *
Class: *
Name / Signature of Legal Guardian: *
Date: *
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