W.T. Woodson Parent Teacher Student Organization Informed Consent and Acknowledgement of Risk Form
2019 Cavalier Cruise – All Night Graduation Celebration
Tuesday, June 4, 11:00 pm – Wednesday, June 5, 5:00 am
IN CONSIDERATION of the right to attend and participate in the Cavalier Cruise, the parent/guardian of the above-identified student and the student hereby:
1. Authorizes permission for the student to participate in the event. This is a ‘lock-in’ event and students will not be allowed to leave that evening.
2. Understands that the event will include such activities as: swimming, mechanical bull riding, obstacle course, and Velcro wall. By consenting to have the above named student participate in this event, you are consenting to allow the student to participate in all activities available at this event.
3. Acknowledges that there is an element of risk involved in any activity involving swimming, jumping, and mechanical bull riding, and certifies that the participant is physically, mentally, and emotionally capable of attending and participating in the activities; assumes all risk of and financial responsibility for any loss or injury to the participant or others that may occur as a result if the participant’s negligence or misconduct; and indemnifies and holds W.T. Woodson Parent –Teacher-Student Organization, the Fairfax County Park Authority and the Fairfax County Board of Supervisors harmless from and against any and all costs, claims, demands, charges, liabilities, obligations, judgments, executions, costs of suit, and actual attorney’s fees incurred or suffered by W.T. Woodson PTSO as a result of, or arising out of, the participant’s negligence or misconduct.
4. Authorizes W.T. Woodson PTSO to obtain or authorize any reasonable incidental and/or emergency medical treatment for the participant in the event the participant’s parent(s)/guardian(s) are not readily located and participant becomes ill, injured, or incapacitated; parent(s)/guardian(s) hereby accept the responsibility to pay for such treatment.
This Informed Consent and Acknowledgement of Risk may not be amended, supplemented or abrogated without the written consent of W.T. Woodson PTSO.
The participant and the parent(s)/guardian(s) signing below on behalf of participant acknowledge that they have read this consent and understand its contents.
Both the parent and the student must accept this agreement.