Student Name *

First Name

Last Name

*

I give permission for my child (“student”) to be transported in the Church van, driven by the individual listed above, to an event at the specified location on the date indicated. I understand that my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or other adult volunteers. I have read, understand, and discussed with my child that: (1) They will be traveling in a motor vehicle driven by an adult and they are to wear their safety-belt while traveling; (2) They are expected to respect each other, the vehicles they ride in, and the people they travel with during the trip; (3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders, other drivers, or objects; and (4) They are to remain in their seats and not be disruptive to the driver of the vehicle.

*

I recognize that by participating in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses. As a condition for the transportation received, I, for myself, my child, my executors and assigns, further agree to release and forever discharge The Greek Orthodox Cathedral of the Annunciation, its Board, the Sunday School Department and their agents, officers, employees and volunteers from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation.

*

I have read this entire waiver and permission form, fully understand it, and agree to be legally bound by its terms.

Signature *

I understand that checking this box and providing my name below constitutes a legal signature.