EVENT PERMISSION AND WAIVER
This Permission must be returned to the GĐPT Hoa-Nghiêm on the date established in the event information or children will not be allowed to participate in the event. Failure to complete this Permission will necessitate that your child not participate in the event.  No written notes or telephone calls will substitute for this Permission.

* Please complete this waiver form by December 4th, 2021
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Email *
Event Name: *
Event Location: *
Event Date and Time: *
Your Child Name: *
Acknowledgements
I, the undersigned, am the custodial parent/legal guardian of child name above.
I have received and reviewed the event information provided by the GDPT Hoa-Nghiem and agree to the terms, conditions, manner of transportation and costs contained therein and request that Participant be to allowed participate in this event.
     
EMERGENCY MEDICAL CONSENT:  
I hereby warrant that to the best of my knowledge, the Participant is in good health and physically able to participate in the camp and I assume all responsibility for the health and physical condition and ability of the Participant to participate. In the event that Participant is in need of immediate medical care, I authorize and give permission for Participant to be transported to a hospital/clinic/medical facility for evaluation and emergency medical or surgical treatment, including any necessary X-ray examination.  I authorize any licensed physician or medical center to treat participants.   I accept full responsibility for any medical or hospital bills associated with the care of the Participant.
LIABILITY WAIVER:  
In consideration of the arrangement set forth herein, I do on behalf of myself, Participant and our respective heirs, successors, assigns and next of kin, release, waive, hold harmless, defend and covenant NOT TO SUE, GDPT Hoa Nghiem, and each of their respective leaders and volunteers from any and all actions, claims, demands or liabilities, including without limitation, those for personal injuries or property damage, that I and/or Participant may suffer due to illness or injury suffered by Participant as a result of, or in connection with, participation in the Activity, including the administration of authorized medications, medical treatment and any consequences that may arise as the result of said treatment, including without limitation, travel to and from the Activity, housing, meals and collateral entertainment to the fullest extent permitted by law.
Parent Signature Name: (type) *
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Phone # : *
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