AGO After-School Program Registration (WCS)
By typing MY NAME below...I am stating my interest in my student's participation in Arcadia Guided Outdoor Education (AGO) programming as it relates to Wasatch Christian School’s participation in the Federal EANS Grant. I understand that participating in these activities is potentially hazardous, and that my student should not participate unless they are physically, mentally, and emotionally able and properly trained. I assume full and complete responsibility for any injury or accident which may occur while my student is traveling to or from the activity or during the activity. I waive, release, and discharge AGO and its representatives of all liability, claim, action, or damage that may arise including that which is caused by negligence or action/inaction of AGO representatives. I authorize AGO representatives and/or other medical personnel to obtain or provide routine or emergency medical care for my student, to transport the student to a medical facility, and to provide treatment they consider necessary for the student’s health. I agree to pay all costs associated with this care and transportation. I understand that AGO reserves the right to require a physical or psychiatric release for participation. By registering a child under the age of 18, I warrant that I have the legal authority to enter into this agreement on their behalf.
Student Name, Grade, and Birthday
The following allergies (food, plant, medicine, etc.), health issues or medical conditions (past or present), or other information would be helpful for AGO to know about my student:
If it changes, I will update my contact information, as well as my student’s medical information with AGO. My current PHONE NUMBER and EMAIL is:
I _____ grant permission for my student’s photo to be published on AGO’s website and social media feeds.
Which day of the week works best for your student to participate in this after school program?
Never submit passwords through Google Forms.
This form was created inside of Arcadia Guided Outdoor Education.