I/We, the undersigned parent/guardian of Student Name listed below, a member of the 2022 Ponderosa Senior Class, authorize the PHS Sober Grad Night committee, representatives for the undersigned in our absence, to consent to x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and/or hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician or surgeon licensed under the Medical Act, whether such diagnosis or treatment is rendered at the office of said physician or any duly licensed medical facility.  It is understood this authorization is given in advance of any specific diagnosis, treatment, or hospital care required, but is given to provide authority and power on the part of the aforementioned PHS Sober Grad Night Committee representatives to give specific consent in any medical emergency or hospitalization which the aforementioned physician, in the exercise of best judgment, may deem advisable.  This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. The undersigned agrees to adhere to all the rules of the PHS Sober Grad Night event and bear all costs incurred as a result of any medical treatment and/or destruction/action by the student.  This authorization will remain in effect for the duration of the event including but not limited to the student’s check-in at Ponderosa High School.

I/We agree to hold the PHS Sober Grad Night Committee and its volunteers harmless from any and all liability, actions, and causes of action, debts, claims, and demands of every kind and nature which may arise by or in connection with participation by my/our student/ward in any activities related to PHS Sober Grad Night activities.

I/We, the parent/guardian of 2022 Ponderosa Senior Class, understand that this is an ALL NIGHT Grad party and understand the only way for my child to be released prior to the end of the event is to come in person and sign them out.  I will bring Photo ID with my to provide proof of identity.

I/We authorize Ponderosa High School Sober Grad Night to utilize any photographed or video graphed images in brochures, flyers, displays, and website or for other promotional purposes.