As part of the consideration for my child’s participation in this activity, I hereby release, hold harmless, and forever discharge Willow Oak Montessori Charter School, Inc. (“the School”), its employees and agents, and any volunteer chaperones from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or my child, or to any property belonging to me or my child, while my child is participating in the program, except for damages caused by the negligence of the School, its agents and employees.
Medical Consent: In the event of an emergency or non-emergency situation requiring medical treatment, I hereby grant permission for any and all medical and/or dental attention to be administrated to my child, in the event of an accidental injury or illness, until such time as I can be contacted. This permission includes, but is not limited to, the administration of first aid, the use of an ambulance, and the administration of anesthesia and/or surgery, under the recommendation of qualified medical personnel.
I have read and I understand this document, including the release and hold harmless portions of it. I understand and agree that it is binding on myself, my child, our heirs, assigns, and personal representatives. By inserting my name below, I acknowledge that I am the parent or guardian of the child specified below, and that I am at least 18 years of age.
Please type your name below as your official signature.
