Permission to Participate and Waiver for Field Trip

Event/Field Trip: St. Cloud State University
Date: November 1, 2019
Location: SCSU Campus

Through the submission of this form and providing the information below,  you agree to the following:

 I give my permission for the named student to participate in the career center sponsored event detailed on this form. I acknowledge that this field trip may involve certain risks and obligations which I am prepared to accept. These risks and obligations may include, but are not limited to the following:

- I understand and the student agrees to abide by the district rules and applicable state, federal, or local laws.

- Following appropriate medical consultation, I have determined that the student's health is adequate to participate safely in this program. In the event of an emergency, I authorize treatment by emergency medical personnel.

- I understand that the School Board does not or may not carry any insurance relative to the trip or for any injuries to the student. I represent that the student has insurance through my own insurance carrier. If I do not have family coverage, I will assume responsibility for any medical bills associated with this field trip.

- I understand that the necessary arrangements, plans and precautions will be taken for the care and supervision of the student during the trip.  I also understand that I will be responsible for paying all expenses related to sending the student home from trips for disciplinary reasons or illness.

- I hereby release and waive and further agree to indemnify, hold harmless reimburse the School Board, the individual members, agents, employees, volunteers and representatives thereof, as well as trip supervisors, from and against any claim which I, any other parent or guardian, any sibling, the student, or any other person, firm or corporation may have or claim to have, known or unknown, directly or indirectly, for any losses, damages or injuries arising out of, during, or in connection with the student’s participation in the trip and related activities or the rendering of emergency medical procedures or treatment, if any.

Please know the following:

- Completing this form does not guarantee a spot on the field trip.  Final approval will be determined by Career and College Specialists at each high school.

-Students that sign-up for the field trip MUST ride the bus to and from any event.

-The district is requesting this information for the student to participate in a field trip.  The information may be used for communication purposes and to facilitate participation.  The parent/guardian is not required to provide any private data but the failure to supply such information may preclude the student's participation.  The information on this form may be released in accordance with the Minnesota Government Data Practices Act and federal law.