Pope High School
Freshman Orientation

STARS Program 2008

Permission Form

I _______________________________ give my student_____________________
      (Parent’s Name)                                                           (Student’s Name)

permission to participate in the Freshman Orientation STARS Program at Pope High School on August 5, 2008
from 12:00 PM to 2:30 PM.

The District does not or may not carry any insurance relative to any trips, including the cost of the trip, or for injuries to the student. I represent that the student has insurance either through the student accident insurance offered by the District or through my own insurance carrier.

If any emergency medical procedures or treatment are required by the student should the student take a trip or is involved in an activity, I consent to the club sponsor(s) taking, arranging for, and consenting to the procedures or treatment in his/her or their discretion.

I agree to release, indemnify, and hold harmless the Cobb County School District (District), its Board of Education, and its employees, agents, or assignees, as well as its approved adult sponsors ("District Indemnitees") from and forever promise not to sue them on any and all claims, demands, rights, causes of action, liabilities, losses, damages, costs and expenses (including reasonable attorneys’ fees), whether known or unknown, that I, any other parent or guardian of the above-named student, or the student may have or may allege to have against the District Indemnitees or which may be brought against the District Indemnitees arising out of or in any manner relating to the student’s participation in a club or organization, including but not limited to the rendering of emergency medical procedures or treatment.

 

Name of Student (PLEASE PRINT) Signature of Student Date _________________________________________

Name of Parent/Guardian (PLEASE PRINT) ______________________________________________________

Signature of Parent/Guardian________________________________________________________                       

Date________________

Telephone #__________________________ Email Address:___________________________________

(Print clearly)