Multi-Purpose Building Student Waiver
This waiver is for safety and liability purposes in the Multipurpose Building. 
Sign in to Google to save your progress. Learn more
Student's First Name *
Student's Last Name *
Student's Birthdate *
MM
/
DD
/
YYYY
Student's School  *
Required
Student's Grade *
Required
Parent/Guardian's First Name  *
Parent/Guardian's Last Name  *
Parent/Guardian's Phone Number  *
Emergency Contact Name (if not above parent/guardian) 
Emergency Contact Phone Number (if not above parent/guardian) 
Rules and Regulations:

This one time waiver must be filled out, signed by a parent or guardian (electronically or a paper copy) and on file with the Multi-Purpose Building office prior to unaccompanied students entering the building.

*Treat the building and staff with the same respect as       your school building and staff.  

*Sign in with the office every time you are in the building for

anything aside from a school team meeting or practice or

a Linden Community Education program.

*No one under 14 is allowed in the building without a parent,

guardian, coach or other responsible adult. 

*No one under 18 is allowed in the fitness room unless they

are accompanied by a coach or parent. Every individual

must sign the fitness room waiver prior to using any of that

equipment.

*Team rooms, locker rooms and the wrestling room are

off-limits unless there is a legitimate event that necessitates

the use of them.

*No running, dribbling, throwing or bouncing balls in the

hallway. 

*No food or sports balls on the track at any time. 

*Failure to follow the above rules may result in individuals

being asked to leave the building. Repeat offenders will not

be allowed to return to the Multi-Purpose Building without a

school team or group.

*Staff will be present at all times, however your student

will not be under direct supervision by building staff at all

times.

 *
Required
By checking the box below, I (parent/guardian of named student above) hereby agree to give my approval to participate in any and all activities in the Multipurpose Building. I know that participation in any recreational program may result in serious injury and/or death and that protective equipment does not prevent all injuries to participants and do hereby waive, release, absolve, indemnify and agree to defend and hold harmless Linden Community Schools, its employees, instructors, Board of Education, organizers, sponsors, volunteers and other participants from any claim arising out of any injury to my student whether the result of negligence of any other cause. Linden Community Schools is not responsible to lost/stolen/damaged personal items. As a parent/guardian of a participant, I understand that photographs/videos may be taken and I approve Linden Community Schools using the photographs or videos for promotional use.  *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Linden Community Schools. Report Abuse
Google Forms