SCS Off-Site Activity Parent/Guardian Acknowledgement of Risk
Each and every trip that our students take off campus requires your permission. Every teacher will be taking with them the emergency medical forms that were sent home, filled in by you and then returned to the office. These forms are called Demographic Data Updates. If any of that information has changed, please notify the school office immediately.
PROGRAM/ACTIVITY INFORMATION
Program / Activity: Grade 9 & 10 Winter Retreat
Dates: February 12-14, 2020
Teacher in charge: Mr. Long
SCS RESPONSIBILITIES
SCS Administration will make every reasonable effort to ensure or ascertain that:
a. The staff, volunteers and/or service providers involved are suitably trained and qualified.
b. The students are adequately supervised over all aspects of the program/activity.
c. The location(s) used are appropriate and safe for the activity(ies) and group.
d. Equipment used has been inspected and deemed appropriate and safe.
UNDERSTANDING AND ACKNOWLEDGEMENT OF RISK
1. I acknowledge my right to obtain as much information as I require about this program or activity and associated risks and hazards, including information beyond that provided to me by the school or board.

2. I freely and voluntarily assume the risks/hazards inherent in the program/activity and understand and acknowledge that my child may suffer personal and potentially serious injury due to an unforseeable event associated with his/her participation.

3. My child has been informed that he/she is to abide by the rules and regulations, including directions and instructions from the school’s and/or service provider’s administrator’s, instructors, and supervisors over all phases of the program/activity.

4. In the event that my child fails to abide by these rules and regulations, disciplinary action may require his/her exclusion from further participation, or that I be contacted to have him/her picked up, unless I have specified other transport arrangements.

5. I acknowledge that it is my responsibility to advise the board of any medical and/or health concerns of my child which may affect his/her participation in the stated program or activity.

6. I consent that the board, through its employees, agents and officers may secure such medical advice and services as they deem necessary for my child’s health and safety, and that I shall be financially responsible for such advice and services.
TRANSPORTATION
Mode of Transportation: Bus
Company: Hertz
I accept this mode of transportation for this activity. *
POTENTIAL HAZARDS
Sprain, break bone, slip, fall, hypothermia
ACKNOWLEDGEMENT OF RISK
Based on my understanding and acknowledgement of risks as described herein, I agree that my child has my permission to participate in this program / activity. *
Parent's First and Last Name *
Your answer
Student's Last Name *
Your answer
Student's First Name *
Your answer
Email *
Your answer
SIGNATURE
By checking the "I agree" checkbox and clicking the "Submit" button, I indicate my acceptance and delivery of this information. After submitting this form, if I subsequently need to make any changes it is my responsibility to contact the sender of this form. I understand and acknowledge that if I proceed to sign this document electronically that the document will be valid and enforced in the same manner as a hand-signed document that exists in physical form and that a record or signature may not be denied legal effect or enforceability under law solely because it is in electronic form. I understand, agree to and acknowledge the previous paragraph. *
Required
(Optional) PARENT HELP: We need one or two people who are willing to help direct activities outside with the teachers. If you are able to help, please give your name and the days you are able to help.
Your answer
(Optional) KITCHEN HELP: We need two to three parents in the kitchen. The menu is already set; we just need the food cooked while we are at the camp. If you are able to help, please give your name and the days you are able to help.
Your answer
(Optional) BAKING: If you are willing to donate some baking to help treat and fill the students up this would be greatly appreciated. Please remember that we need to remain a NUT FREE food zone. If you are able to help, please give your name and the baking you would like to provide.
Your answer
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