RELEASE, MEMBERSHIP AND ACKNOWLEDGEMENT OF RISK

IMPORTANT: BY SIGNING THIS FORM, BOTH THE STUDENT AND THE PARENT AS MEMBERS ARE AGREEING THAT NO OTHER MEMBERS OF THE SCHS 2013 SAFE GRAD COMMITTEE NOR ANY VOLUNTEER WORKING THAT COMMITTEE WILL BE RESPONSIBLE FOR: 1. 2. ANY INJURY, LOSS OR DAMAGE THAT MAY BE SUSTAINED BY THE STUDENT OF HIS/HER PERSONAL PROPERTY DURING OR IN CONNECTION WITH THE SCHS 2012 SAFE GRAD, OR THE CONSUMPTION OF ALCOHOL BY ATTENDEES OF THE SAFE GRAD, INCLUDING MINORS.

WE ACKNOWLEDGE THAT: 1. 2. WE ARE AWARE THAT SCHS IS NOT INVOLVED OR RESPONSIBLE FOR ANY ASPECT OF THE SCHS 2013 SAFE GRAD. THAT ALTHOUGH THE ORGANIZING COMMITTEE AND VOLUNTEERS ARE ATTEMPTING TO REDUCE THE RISKS INVOLVED IN THIS TYPE OF ACTIVITY, WE ACKNOWLEDGE THE STUDENTS PARTICIPATION IN THE SAFE GRAD MAY INCLUDE UNANTICIPATED RISKS WHICH COULD RESULT IN PHYSICAL OR EMOTIONAL INJURY OR DEATH TO THE STUDENT OR THE THIRD PARTIES OR TO DAMAGE TO PROPERTY AND WE UNDERSTAND THAT SUCH RISKS SIMPLY CANNOT BE ELIMINATED WITHOUT JEOPARDIZING THE ESSENTIAL QUALITIES OF THE ACTIVITY. THE PARTICIPATION OF THE STUDENT IS PURELY VOLUNTARY AND WE AGREE TO PARTICIPATE IN SPITE OF THE POSSIBLE RISKS AND WE ACCEPT AND ASSUME SUCH RISKS. WE AGREE TO BEAR THE COSTS OF ANY DAMAGES OR INJURY INCURRED BY THE STUDENT OR THIRD PARTY AND WE CONFIRM WE HAVE INSURANCE TO COVER ANY SUCH INJURY OR DAMAGES. WE HAVE HAD SUFFICIENT OPPORTUNITY TO READ AND HAVE READ THIS ENTIRE DOCUMENT. WE UNDERSTAND IT AND AGREE TO BE BOUND BY THE TERMS.

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I agree to observe the rules and regulations set out above. ___________________________________ Student Signature I, _______________________, (parent/guardian) give ______________________ permission to attend the Strathcona Composite High School 2013 Safe Grad on May 18th 19th, 2013. I am aware of the attached rules and agree to abide by them. I am aware that the organizers and volunteers at the Safe Grad will not be policing the consumption of alcohol by students, including minors.

______________________________ Phone # (Where parent can be reached during the Safe Grad)

_________________________________ Parent/Guardian Signature

Student Alberta Health Care Number:_____________________________ Medical Conditions, medications or allergies of students that medical personnel should be aware of: _____________________________________________________________________