Please either fill out this online form or download and print the form offline and bring to playgroup.
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Please read the following information carefully. Your signature
indicates that you fully understand and agree to abide by the terms of the Sacramento Friends
This form must be signed in order to engage in the Sacramento Friends
Playgroup. The release may not be altered in any way.
I grant permission to my child(ren) to
attend all Sacramento Friends Playgroup Excursions and Trips. I hereby
grant permission to my child(ren) to participate in Sacramento Friends
Playgroup activities including but not limited to sports, crafts, games,
and special events.
Good behavior is
encouraged at all times. As part of the Sacramento Friends Playgroup it is important to nurture
and direct your child to respect and care for the others in the class. In the event that a behavior
problem constitutes actions harmful to others or is disruptive to the
playgroup, the child may be asked to sit out for the remainder of the day’s
INFORMED CONSENT AND RELEASE
I am voluntarily participating in the referenced activity,
understand that such participation does not establish or imply an
employer-employee or an agency relationship with the Sacramento Friends
Playgroup. I acknowledge and agree that some activities may be of a
hazardous nature and/or include physical and/or strenuous exercise or activity
and understanding this I state that I have no knowledge of any conditions that
would prohibit my child from safely participating. Please note: The Sacramento
Friends Playgroup does not provide any insurance
coverage of any kind for your participation. The Sacramento Friends
strongly recommends that appropriate insurance be obtained
by each participant.
I, and in the event that the undersigned is
under 18 years of age, the undersigned’s parents or guardian, in consideration
of the request and permission to participate in the referenced activity, hereby
assume full responsibility for all risk of injury or loss which may result from
my participation in this activity and hereby AGREE TO DEFEND, INDEMNIFY, HOLD
HARMLESS, RELEASE AND FOREVER
DISCHARGE the Sacramento Friends Playgroup from any and all acts of negligence
and all claims and demands whatsoever, which the undersigned, any third person,
or any persons acting under their behalf, have or may have against the Sacramento
Friends Playgroup, by reason of any accident, illness, injury to or death
of any person or persons, or damage to or loss or destruction of any property
arising or resulting directly or indirectly from participation in the referenced
activity and occurring during said participation, or any time subsequent
thereto. The terms of this release will serve as a release and assumption of
risk for my heirs, executors and administrators and for all of my family
PERMISSION FOR MEDICAL TREATMENT
I, the undersigned, hereby grant the Sacramento Friends
and agents thereof, permission to summon 911 in the event
that myself or my child(ren) require advanced first aid or medical treatment. I
further grant permission to transport myself or my child(ren) to another center
of advanced care. I grant permission to any and all physicians, surgeons,
medical personnel, and emergency medical technicians or paramedics to treat
myself or my child(ren) if such treatment is reasonably required.
MEGAN'S LAW RELEASE
For the safety of my children, as well as other children, I consent to my name being checked against the Megan's Law List.
I grant the Sacramento Friends Playgroup at its discretion and free of charge, permission to use still
photography of myself or my child(ren) participating in District sponsored
recreation programs for the purpose of publicizing said programs.