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MVHS ROBOTICS PERMISSION SLIP

STUDENT PARTICIPATION IN NON-REQUIRED,

POTENTIALLY DANGEROUS ACTIVITIES

I want my son/daughter/legal charge, to participate in MVHS Robotics Team activities which include working with hand tools, power tools and traveling via plane, bus, van or car.

I UNDERSTAND THAT THIS ACTIVITY IS INHERENTLY DANGEROUS and that my son/daughter/legal charge could be injured or killed even if the activity is conducted with due care by all concerned.

I AM FULLY AWARE OF THE RISKS and hazards inherent in my son/daughter/legal charges engaging in this activity and I voluntarily elect, both on my own behalf and on behalf of my son/daughter/legal charge, to have him/her engage in that activity, knowing that the activity is such that my son/daughter/legal charge may be injured or killed even if the Mountain View-Los Altos Union High School District utilizes care. I also know that the school district is not a guarantor of my son/daughter/legal charges safety and financially could not conduct this activity if it bore the risk of injury or death arising out of the same. I THEREFORE VOLUNTARILY ASSUME ALL RISKS OF LOSS, DAMAGE, INJURY OR DEATH TO MY son/daughter/legal charge arising out of his/her participation in this activity.

IT IS MY INTENT BY THIS CLAUSE TO EXEMPT AND RELIEVE THE MOUNTAIN-VIEW-LOS ALTOS UNION HIGH SCHOOL DISTRICT, ITS OFFICERS AND AGENTS FROM ANY AND ALL LIABILITY FOR PERSONAL INJURY, WRONGFUL DEATH OR PROPERTY DAMAGE ARISING OUT OF MY SON/DAUGHTER/LEGAL CHARGES IN THIS ACTIVITY EVEN IF SUCH INJURY, DEATH, OR DAMAGE BE CAUSED BY THE NEGLIGENCE OF THE SCHOOL DISTRICT OR ITS OFFICERS AND AGENTS.

I further agree to indemnify, save harmless and defend the school district, its officers, agents, employees and representatives from and against all death, injuries, damages, whether incurred by judgement or settlement, including legal expense and attorney's fees, of whatever nature occurring during, by reason of, or arising out of my son/daughter/legal charge‘s participation in said activity, and I shall assume the defense and for settlement of any claim, suit or action brought against the school district or its officers, agents, employees or representatives to recover any such damages.

Further, on behalf of myself, my son/daughter/legal charge, and our personal representatives, assigns, heirs and next of kin, I hereby release, waive, discharge and covenant not to sue the Mountain View-Los Altos Union High School District, its officers, employees, agents or representatives for loss or damage and any claims or demands therefor on account of injury or death to my son/daughter/legal charge, whether caused by negligence of the school district or its employees, where such injury or death occurs during, by reason of, or arising out of this activity.

 

                                   Date:                                                                                                                 

                     Student name:                                                                                                                  

 

Parent/Guardian signature:                                                                                                                  

 

                         Print name:                                                                                                                 

 

This form should be printed, filled out, and returned to Wyn Schuh before a student can be an active member on the team.