Robotics Travel Permission Slip - 2016 to 2017

Please fill out the form completely and carefully. If a specific section does not apply to you then simply put N/A
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Xavier High School and team mentors, members and agents will not be responsible or liable for students being transported in personal vehicles. This includes students transporting themselves and/or other students; parents transporting their sons and/or other students; faculty/staff/mentors transporting students

    The undersigned hereby releases, holds harmless and indemnifies Xavier High School, its mentors, agents and employees, from any and all liability due to personal injury or property damage resulting from or sustained while participating in this trip.
    This is a required question

    Student Section

    To be filled out by the student attending the trip.
    This is a required question
    This is a required question