Permission Slip and Waiver Form
Robbinsdale Area Schools Community Education
Discover U Programs for Youth
[If you registered your child online, you have already given us this information and it is NOT necessary to submit this form.]
As a parent/guardian, I give permission for my child to participate in DISCOVER U classes. This program is not required by the Robbinsdale Area School District.
In addition, I give permission for my child to participate in all off-site classes and field trips associated with DISCOVER U classes, including transportation to and from such off-site classes and field trips.
I am aware of the inherent risks associated with these activities and that all risks cannot be prevented.
If my child should require emergency medical treatment, I consent to such treatment. I acknowledge that the school district does not provide accident or health insurance for students, and I agree to be responsible for any medical bills incurred as a result of emergency medical treatment.
To the maximum extent permitted by law, I hereby hold harmless and release the school district, its officers, employees and volunteers, from any claims for damages or injury to my child or property, which may arise from my child’s participation in the above program and all related activities.
This release and holds harmless clause does not apply to intentional or negligent acts of the school district, its officers, employees and volunteers that cause harm to my child. However, by signing below, I agree that the school district will not be responsible to pay any deductible on any insurance our family may have, if a claim is made that arises out of my child’s participation in this program.
If I am concerned about the program identified above or any of the activities or risks associated with the program, I understand that I can contact the Robbinsdale Area Schools. Aviva Hillenbrand, 763-504-4905.
Class / Activity Name
Other (specify below)
Class Name ONLY if the 'Class / Activity Name' above is 'Other'
Class Number ONLY if the 'Class / Activity Name' above is 'Other'
Class Start Date ONLY if the 'Class / Activity Name' above is 'Other'
2nd Child's Name (if applicable)
2nd Child's Grade
My child(ren)'s picture may be used for publicity purposes.
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