8th Grade Bike Trip Release Form
8th Grade Bike Trip Release Form
8th Grade Bike Trip Release Form
Student Name:
Parent/Guardian:
Home Address:
Name: Phone:
1. All participants are required to have an up-to-date tetanus immunization. Does this student meet this
requirement? YES NO
By signing below:
I give permission for non-prescription medication (e.g., ibuprofen/aspirin) to be given to my child by the
parent in charge. In case of an emergency, I give my permission for the parent in charge to take whatever
emergency measures (e.g., first aid, disaster evacuation) are deemed necessary for the care and protection of
my child while under their supervision.
1
I acknowledge that in the event of a medical emergency, my child will be transported to the nearest hospital
by ambulance if the local emergency resource (i.e. police or rescue squad) deems it necessary, for care and
treatment. (Any directions to the contrary should be specified at the bottom of this form and signed). I will
be responsible for the cost of transportation. It is understood that in some medical situations, local
emergency resources may need to be contacted before the parent/guardian, child's physician, and/or other
adult acting on the child's behalf.
I give my permission for my child to participate in the Bike Trip, which is not sponsored by Highland
Catholic School. I understand that the risks associated with this Bike Trip could result in injury and/or
death to my child. I assume these risks and, knowing them, give my child permission to participate. I
understand that the individuals overseeing the Bike Trip are not liable for any injuries or damages due to
transportation, biking, camping, on-site activities, or related risks, and/or the actions or omissions of such
individuals or any other entities being released. I also understand that the General Insurance Program for
Highland Catholic School/Archdiocese of Mpls/St. Paul will not cover this non-school sponsored activity. I
agree to hold harmless and indemnify Highland Catholic School/Archdiocese of St. Paul/Mpls and the
individuals overseeing the Bike Trip from any claim, judgment, or expenses related to my child’s
participation in this activity.
Signed: Date: