PHS After-Prom 2022 Waiver

TO PARENTS

1. The student will only be permitted to travel to and from the destination by the means of transportation designated by the sponsors and indicated below.

2. By signing this form, I am acknowledging I am aware there will be swimming at After-Prom. I will contact an After-Prom committee member if I am concerned about my child's ability to swim.

Nature of Activities: After-Prom is sponsored by the After-Prom Committee, made up of parents of PHS juniors & seniors. After-Prom will be held at Lenexa Rec Center in Lenexa, KS.

Date of Activity: Saturday, April 9th leaving the school parking lot at 11:15 pm and returning Sunday, April 10th approximately 4:30 a.m.

Means of Transportation: We will be transporting students by the activity bus and transit van provided by USD 344.

Method of Supervision: Students will be supervised by After-Prom Committee & parent volunteers

Location of Activity: Lenexa Rec Center 17201 W. 87th St. Pkwy. Lenexa, KS 66219

Name of student*

First NameLast Name

While on this After-Prom 2022 trip, I will abide by all rules posted at the facility, and mentioned/explained to me in person while on the bus or in the facility. I will be respectful of those around me at all times. I am aware I am unable to leave the event until the bus returns to the school parking lot. If I fail to do this or anything else the sponsor deems necessary, I will call my parent/guardian to come and pick me up immediately.

Signature of Student*

PARENTS

I hereby give my permission for my child to take part in the activity as outlined above, and hereby agree to well and sufficiently indemnify and save harmless the After-Prom Committee and keep the After-Prom Committee, volunteers, and chaperones indemnified and harmless of any and all demands, actions, proceedings, liability claims, damages, together with the costs and expenses thereof, that may hereafter at any time be made or brought by or on behalf of my child for any injury, loss, damage, expense and costs sustained or alleged to have been sustained by my child howsoever arising from the aforesaid activity provided. I hereby consent to my Child’s receipt of medical treatment which may be deemed advisable in the event of injury, accident or illness during this event. This release, indemnification, and waiver shall be construed broadly to provide a release, indemnification, and waiver to the maximum extent permissible under applicable law.

PARENT/GUARDIAN NAME*

First NameLast Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Signature of Parent/Guardian*

PHS AFTER-PROM 2022