OHLONE ELEMENTARY PTA WAIVER FORM 2022-23

PARENT APPROVAL & STUDENT, FAMILY, PARTICIPANT WAIVER

The Ohlone Elementary PTA offers a wide variety of engaging in-person and virtual events throughout the school year. Participation in these events is optional, but it is a requirement that all participants (students, siblings, parents, guardians, etc) of these events either sign the Ohlone PTA Liability Waiver or have a parent or guardian sign on their behalf.

Thanks in advance for signing the waiver and we look forward to you (and your family) participating in Ohlone PTA events this year!

*** Complete by Friday, August 26, 2022 ***

The following Ohlone student(s) will participate in Ohlone PTA events during the 2022-23 school year:

Student 1 - First Name *

Student 1 - Last Name *

Student 1 - Room #

Student 1 - Teacher

Student 2 - First Name

Student 2 - Last Name

Student 2 - Room #

Student 2 - Teacher

Student 3 - First Name

Student 3 - Last Name

Student 3 - Room #

Student 3 - Teacher

The following family members will participate in Ohlone PTA sponsored events during the 2022-23 school year:

Please list the names of all additional family members who will participate in PTA events *

The undersigned parent or guardian assumes all risks in connection with the family’s participation in any and all of the PTA sponsored activities.

I, the undersigned participant, intending to be legally bound, do hereby for myself and heirs, executors, administrators and assigns, forever waive release and discharge the California State PTA, all PTA officers, employees and agents from all liability, claims or demands for any damage, loss or injury to the student, the student’s property, or parent’s property or to myself in connection with participation in these activities, unless caused by the negligence of the PTA.

I do hereby certify that to the best of my (our) knowledge and belief said parties are in good health. In case of illness or accident, permission is granted for emergency treatment to be administered. It is further understood and agreed that the undersigned will assume full responsibility for any such action, including payment of costs.

I attest and verify that I am physically fit and able to participate in this event and acknowledge that I am aware of the inherent risks in participating in any athletic event.

By attending Ohlone PTA events and meetings, including those held online, I grant permission to the Ohlone PTA to record photographic, audio, video and digital images (including minors) while in attendance and release the Ohlone PTA from all claims and liability related to said photographs, audio, video and digital images.

Parent/Guardian Signature *

clear

Date Signed * +

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *