Name of Student (a release of liability form must be completed for each student)
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Name of Parent or Guardian signing below
*
First Name
Last Name
I, the parent/guardian of the above listed minor student, do hereby consent to my child’s participation in all classroom activities, outdoor activities including intramural sports, science experiments and general outdoor play. I also agree to forever release Outreach Alliance Supporting Neurodevelopment (OASN), Ocala Preparatory Academy, it's staff, volunteers, board of directors, Heritage Management, KidspOT/Laurel Baxla, OTR/L, agents, and any and all individuals and organizations assisting or participating in all classroom activities, outdoor activities including intramural sports, science experiments, general outdoor play and group therapeutic interventions. (“the Releasees”) from any and all claims, rights of action and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from personal injuries including, but not limited to, death, illness, injury and/or disease, and including any death, illness, injury, to my child or property damage resulting from my child’s participation in any activities. I also promise, to indemnify, defend, and hold harmless the Releasees against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, arising from personal injuries to my child or property damage resulting from my child’s participation in all classroom activities, outdoor activities including intramural sports, science experiments and general outdoor play. I further affirm that I have read this Consent and Release Form and that I understand the contents of this Form. By signing this Form, I affirm that I have decided to allow my child to participate in all classroom activities, outdoor activities including intramural sports, science experiments and general outdoor play with full knowledge that the Releasees will not be liable to anyone for personal injuries and property damage my child or I may suffer in all classroom activities, outdoor activities including intramural sports, science experiments and general outdoor play while on the the property of OASN and Ocala Preparatory Academy.
*
Submit
Submit
Should be Empty: