PARENTAL CONSENT AND RELEASE FORM FOR TRANSPORTATION
FIGHTERWITHIN MMA PARENTAL/GUARDIAN CONSENT FOR:
Acknowledgement of Personal Liability
My Child to Ride with Private Drivers
My Child to Ride with Another Student Participating in Activity
I, (parent/guardian), give permission for my child, {name}, to be to be transported to, and to participate in, the FighterWithin Mixed Martial Arts LLC. After School Program, henceforth known as After School Program, for the duration of the school year in which my child is registered. I understand that this program involves travel from the participant’s school to the program facility.
CONDUCT DURING ACTIVITY
I understand that my child’s participation in the activity is a privilege, and not a right. I acknowledge that I have spoken with my child about my child’s need to comply with the specific rules and requirements established for this activity; all District policies and procedures; rules of conduct set forth in the Student Code of Conduct; and state and federal regulations and laws. I understand that all District rules and policies apply to my child and the other students during the course of the transportation.
TRANSPORTATION PERMISSIONS AND WAIVER
I also understand that private drivers, a teacher, an administrator, or the parent of another student participating in the activity, may be used to transport students to and from the schools, the facility, and activities. The owner of the vehicle is required to carry bodily injury insurance. The district’s insurance does not cover damages arising from, or related to, the operation of any private vehicle, failure to follow the directed driving route, or any personal negligence related to this activity. Any damages/harm resulting from a parent/guardian/or other designated driver (including student-drivers), arising from the operation of a motor vehicle in relation to the above listed activity, is hereby waived.
Please initial on the space to the left of the statement below to acknowledge your acceptance of the following permissions.
I, (parent/guardian), give permission for my child, {name}, to ride in a vehicle driven by a driver that is designated by FighterWithin Mixed Martial Arts, LLC and driven to the facility, FighterWithin Mixed Martial Arts, LLC.
ACKNOWLEDGEMENT OF PERSONAL LIABILITY AND WAIVER
I also understand that this transportation may expose my child to some risks and I assume any such risk that may arise therefrom. I accept full responsibility for all medical expenses for any injuries that might occur to my child by reason of his/her participation.
By signing this form, I hereby release FighterWithin MMA, teachers, volunteers, and designated drivers from and against any and all claims, demands, actions, complaints, suits or other forms of liability that any of them may sustain (a) arising out of my child’s failure to comply with local, state, and federal laws, procedures, and the Code of Conduct; (b) arising out of any damage or injury caused by my child; or, (c) arising out of a parent/guardian/or other designated driver’s operation of a motor vehicle in relation to this activity. I also agree to indemnify and hold harmless the released parties from the released claims, including any and all related costs, attorney fees, liabilities, settlements, and/or judgments.
I confirm that I have carefully read this CONSENT AND RELEASE and agree to its terms knowingly and voluntarily. I also confirm that I am the parent or legal guardian of the child or I am a student 18 years or older.
I have signed this CONSENT AND RELEASE this date of {sign_date}.
This consent and release has been read and is understood by me.
{name}
Student's Name
{sign_date}
Printed Name of Student's Parent or Legal Guardian and Date
{start_date} until {expiration_date}
School Year In Which This Waiver Is Valid