Student Volunteer Permission Slip Student Name* First Last Email for reminders and notifications purposes.* Age*131415161718 or older by March 2022Event*We have 2 different times for volunteer to choose from. Please select one.5:30pm-8:30pm Gala 2023, March 46:30pm-9:30pm Gala 2023, March 4Medical Information and ReleaseIn the event of an emergency, I give permission to transport my child to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. If you are unable to reach a parent/guardian, contact: Alternate Contact Name:* First Last Alternate Contact Phone*Pertinent Medical Conditions (if applicable)Please furnish medical information about your child/ward, which may be pertinent to his or her participation in the above-identified activity.Digital Signature: Parent/Guardian ConsentIn consideration for my child/ward's participation. I agree to reimburse and indemnify the parish/school for all reasonable legal and court fees incurred by parish/school in defending a lawsuit that I or my child/ward may bring against the parish/school which relates to the above named activity if the parish/school is found not legally liable by the courts and prevails in the lawsuit. If the parish/school is found legally liable for injuries sustained by child/ward, this paragraph will not apply. I certify that I have an understanding of this agreement and any risks and hazards associated with the activity described above that my child/ward will be participating in. I further understand that I had the opportunity to fully discuss this agreement with a representative of the parish/school to clarify any concerns or questions about the activity or this agreement that I may have had. Parent Name* First Last By entering my full name, I attest that this constitutes my legal electronic signature on this form.Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Today's Date* MM slash DD slash YYYY Δ
