Registration Disclosures:
Student Participant: (Listed in above form)
PARENTAL CONSENT-MUST BE SUBMITTED IN ORDER TO
PARTICIPATE
In consideration of the registering student
participant being allowed to participate in any way with activities related to
Aviation Career Day, including, but not limited to, activities at Brunswick
Golden Isles Airport, classes, commemorative photos, and/or lunch during the
event; I, the parent or guardian of the above-named Student Participant, agree
to the following as evidenced by my submission of this form, I also certify
that I am a legally authorized parent or guardian empowered to sign this document
on behalf of the above-named minor Student Participant.
MEDICAL
1. I certify that my minor child is not currently
under a physician's care, is in good, health, and that I have no reason to
believe that he/she is not physically, mentally, and/or emotionally capable of
safely participating in the activities described on the reverse side of this
Parental Consent form.
2. That should my minor child sustain injury or
illness while participating in the activities described above, I hereby
authorize any emergency first aid, medication or surgery deemed necessary by
licensed medical personnel. I give permission for the attending medical
personnel to execute on my behalf any necessary medical documents or permission
forms and to act in my behalf if l am not able to do so.
3. That I understand my minor child will not be
provided medical care (except on an emergency basis) for any injuries or
disease occurring during the activities described above. I certify that I have
sufficient medical insurance coverage to pay for any medical treatment should
an injury occur. I agree to reimburse any responding medical facility or
medical professional for any medical care provided.
RELEASE
1. I hereby authorize my minor child
("Student Participant") to participate in all activities during
Aviation Career Day, which include, but are not limited to, all activities,
classes and tours provided during the day; and lunch.
2. I assume all risks and accept all
responsibility for any damages or any injury or accident that might result to Participant
from his or her participation in Aviation Career Day resulting from any of
Participant's own actions, inaction or negligence and/or the actions, inactions
or negligence of others, or the conditions of the premises or any equipment
used or other risks not known or reasonably foreseeable at this time.
3. I intend to be legally bound, and do
hereby release, waive, discharge and covenant not to sue the organizers of
Aviation Career Day, Brunswick Golden Isles Airport, Glynn County Board of
Education, The Glynn County Airport Commission, The Brunswick and Glynn County
Development Authority, Glynn County, its administrators, officers, directors,
agents, coaches, teachers, instructors, non-student participants and exhibitors
or other employees or volunteers, or the owners and leasers of the premises and
equipment used to conduct the event, all of which are hereafter referred to as
the "releasees", from any and all liability to each of the
undersigned, his or her heirs, and next of kin for any claims, demands, losses
or damages on account of any injury, including death and permanent or partial
disability or damage to property, caused or alleged to be caused by the
negligence of the releasees, excepting the sole negligence of said
releasees, or otherwise in connection with and/or arising out of Student
Participant's travel to, participation in, and return from the event.
4. I agree to indemnify and hold harmless
the organizers of Aviation Career Day, its administrators, officers, directors,
agents, teachers, instructors, non-student participants and exhibitors or other
employees or volunteers, or owners or leasers of the premises and equipment
used to conduct the event against all civil actions or claims for loss or
damage to my property or the injury, death, disease, or disability to minor
Student Participant that is caused or alleged to have been caused in whole or
in part from any act having any connection with and/or arising out of Student
Participant’s participation in the event.
5. My child’s information may be shared with
various colleges and schools participating at the event for purposes of
providing college-level information to my child and to me; colleges warrant and
represent said material will be maintained in strict confidence.
6. By submitting this form I understand that
I will receive the monthly Glynn County Airport Commission Newsletter.
PHOTOS
• I also specifically APPROVE photos of my minor
child participating in the event to be used by news media covering the event
and by the organizers in documenting and promoting the event. News
organizations may use them in the print and on-line versions of their
publications. Photos of my minor child participating in the event may
also be posted on the official Facebook pages of this event, Civil Air Patrol, Gulfstream, EAA, Glynn County Airport Commission, Brunswick Golden Isles Airport, and/or other
hosts and sponsors of the event.
SUBMITTING THIS FORM ENSURES I HAVE READ THE ABOVE
RELEASE AND HOLD HARMLESS AGREEMENT AND UNDERSTAND THAT I HAVE GIVEN UP
SUBSTANTIAL RIGHTS AND MADE CERTAIN IMPORTANT REPRESENTATIONS AND I HEREBY
EXECUTE THE RELEASE VOLUNTARILY.