Trip Permission Slip

 

                       Parker County Young Marines

                                 Permission Slip

 

My Young Marine _________________________________ has my permission to go on the USS Cavalla WWII Submarine, Galveston Texas trip with the Parker County Young Marines for and overnight Encampment on April 28th & 29th, 2018.

 

I will not hold the staff, headquarters, or any part of the Young Marines liable for accidents that could occur.  In the event that an accident should occur, please transport my child to (hospital/doctor) ___________________________________

 

My Young Marine will conduct himself/herself in such a manner that represents the Parker County Young Marines.  He/she will dress appropriately, and respond accordingly.

 

My Young Marine does ____ or does not ____ have allergies.

Please list allergies: __________________________________________________

 

My Young Marine will ____ or will not ____ be on medication at the time of the above mentioned trip/excursion/encampment.

 

Please list any Medications: __________________________________________________________

 

Dosage: ___________________________________________________

 

Times to be given: ___________________________________________

 

Parent Contact Information

 

Name: ____________________________________________________________

 

Address: __________________________________________________________

 

City: __________________________________, Texas, Zip: ________

 

Phone (H): _______________________ (C): _______________________

 

Parent/Guardian Signature: ___________________________________________________________

 

Dated this _____________ day of __________________________, 2018

 


EDUCATION PROGRAM - ACCIDENT WAIVER AND RELEASE OF LIABILITY OPS-FRM-01-0

 
Revision: 0  Revision Date: 13-Apr-18
 1
Activity/ Event: Overnight Sleepover Date of the Event: ___________________ I hereby assume all risks of participating and/or volunteering in this event, including, by way of example, and not limitation, any risks that may arise from negligence or carelessness on the part of persons being released, from dangerous or defective equipment or property owned, maintained, or controlled by "Them", or because of their possible liability without fault. "Them" is identified as the following: 1. American Undersea Warfare Center (including but not limited to the ex-USS Cavalla Submarine and ex-USS Stewart Destroyer Escort)  2. Cavalla Historical Foundation 3. City of Galveston 4. Galveston Park Board of Trustees of the City of Galveston 5. Seawolf Park I certify that I am physically fit and have not been advised not to participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this event or activity. I release and forever discharge "Them" and their respective employees, officers, directors, shareholders, affiliates, representatives, of and from all liability, claims, demands, and damages, costs, expenses, actions, and causes of action in respect to death, injury, loss or damage arising from participation of this events.  I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, injury, or illness during this activity.  The accident waiver and release of liability shall be construed broadly to provide release and waiver to the maximum extent permissible under applicable Texas Law.  I certify that I have read this document and I fully understand its content. I am aware that this is a release of liability and a contract and I sign it of my own free will. 
 
              (If Participant is a minor) Child's Name (Print)   Parent/Guardian Name (Print)
 
             Parent/Guardian Signature     Date
 
Emergency Contact Name, Number, and Relationship to Participant: 

 
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