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Sugar Rush 5k Student Minor Form(1)

Sugar Rush 5k Student Minor Form(1)

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Fundraising event. Registration for Student/Minors
Fundraising event. Registration for Student/Minors

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Published by: Shelly Stewart Truax on Oct 24, 2012
Copyright:Attribution Non-commercial

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10/24/2012

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Sugar Rush 5k for STUDENT/MINOR PARTICIPANTS
(17 YRS OLD AND UNDER)PARADIGM HIGH SCHOOL EVENT PARTICIPATION Consent & Waiver
ALL of the following information must be completed or you will not be able to participate in the 5k 
_______________________________ _____________________________ ____________Student/minor participant
Name (please print)
Student/minor participant
Signature Date_____________________________ __________________________ ___________Parent/legal Guardian Name (Please print) Parent/legal Guardian signature DateHome phone# (____) _______________ Cell/other phone #(____) _____________________ I am a Paradigm student _____ I am not a Paradigm student but am a minor
Gender ____ Male ____ Female Core
teacher’s name____________________ 
 
By signing above, the minor and parent/legal guardian of the minor understands, acknowledges and agrees:
1.
 
That the above signed parties have read and understand all the information contained in this consent form.2.
 
That participation in the paradigm high school 5K Race will expose the minor to certain unavoidable, unpredictable, andinherent risk and dangers.3.
 
That the minor is physically fit and has not been advised otherwise by a qualified medical person.4.
 
That the minor has been instructed by the parent/legal guardian to:a.
 
Follow all instructions given by event/activity officials and supervisors.b.
 
Follow all Paradigm High policies and procedures, and comply with all applicable laws and ordinances.c.
 
Follow all school rules that may be applicable to this event/ activity.d.
 
Conform to usual and customary standards of good citizenship, good decorum, and common courtesy.5.
 
That Paradigm High does not carry any medical insurance coverage for accidental personal injury resulting from participationin this event/activity.6.
 
That if during the course and scope of this event/activity the minor needs medical attention, the parent/legal guardianunderstands that reasonable efforts will be made to contact the parent/legal guardian. In the meantime, the parent/legalguardian consents to an event/activity official taking, arranging for, and consenting to the medical treatment for the minor.The parent/legal guardian of the minor will be responsible for all costs associated with such medical treatment.7.
 
To the maximum extent allowable by law, the undersigned participant, in consideration of participating in the Paradigm High5K Run, here by releases, indemnifies, and holds harmless Paradigm High, the school hosting/ sponsoring the event/activity,district and school employees, agents, coaches, volunteers, supervisors, officials, and other participants of and from any and
all claims, liabilities, and expenses (including costs and attorney’s fees) arising from personal injury, illness, death, pro
pertydamage, theft, and all other losses arising directly or indirectly from participating in the Paradigm High 5K Run.
Return this form by Wednesday, Oct. 31
st
 Turn money in to the office

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