Code No.: 702.11R1
TRANSPORTING STUDENTS IN PRIVATE VEHICLES TO DISTRICT ACTIVITIES
Participation Agreement, Acknowledgement of Risks and Release of Liability
I, the undersigned participant (and the parent or guardian if participant is a minor), in consideration of the ANAMOSA COMMUNITY SCHOOL DISTRICT’S (“ANAMOSA”) sponsorship of extracurricular activities voluntarily make the following agreement:
- Agreement to Participate: I hereby desire and agree to participate in Anamosa Community Schools athletics/activities and/or programs (“Program(s)”).
I understand this/these Program(s) is/are a completely voluntary Program(s) being offered by ANAMOSA COMMUNITY SCHOOL DISTRICT in an effort to meet the extra-curricular needs of its students.
- Assumption of Risks: I am aware of, and voluntarily assume, the risks inherent in this/these Program(s) and I understand that my participation could result in injury to myself, perhaps including loss of property, limb, life or permanent physical impairment. I believe that I am in good health and I know of no physical or emotional reasons why I cannot safely participate in the above Program(s). I promise to abide by all of the rules and regulations of the ANAMOSA COMMUNITY SCHOOL DISTRICT and obey the instructions and orders of its employees. I hereby release any claims whether for personal injury, property damage or otherwise, against the ANAMOSA COMMUNITY SCHOOL DISTRICT which may arise out of my voluntary participation in the above activities
3. Transportation: The terms and conditions of the Program(s) have been explained to me. I understand the transportation to and from practices, with the exception of Central Park, is a prerequisite to participation in the Program(s) and that this transportation will not be provided, organized or monitored by ANAMOSA COMMUNITY SCHOOL DISTRICT in any way. Rather, transportation is the sole and absolute responsibility of the student and/or parent/guardian and is not the responsibility of ANAMOSA COMMUNITY SCHOOL DISTRICT. I further understand that any damage or injury resulting from transportation to and from practices shall be my and/or my parents/guardians responsibility and I will not hold ANAMOSA COMMUNITY SCHOOL DISTRICT liable for any reimbursement for such damage or injury.
- Contractual Agreement: I understand that this is a contractual agreement and that no representation of any kind has been made to me as an inducement for the execution hereof. I have read this agreement and I understand its terms. If any portion of this agreement is invalid I expect that the remaining portions of this agreement will be enforced. I have read this agreement and understand its terms and hereby voluntarily enter into same.
Signature of Participant _________________________________
Date ________________________________________________
Approved 5/16/16
