Field Trip Waiver Form
Please fill out form completely. Participant will only be allowed to join events once this waiver is received and verified.
  
  
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Emergency contact must be different than parent / guardian stated above.

  
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I understand that there are risks associated with participating in River Oaks C.O.R.E related activities. In consideration for the privilege to use the facility and/or attend the River Oaks C.O.R.E programs and trips, my signature indicates that I assume the risk of any injuries that myself or my children/wards may sustain while participating in any activity at River Oaks C.O.R.E and for any injuries which myself or my children/wards may sustain while on the premises of River Oaks. I insure that I am or my child/ward is physically and mentally able to participate in physical activities and have been examined by a licensed medical physician within one (1) year prior to attending River Oaks C.O.R.E programs.

 

I give permission for River Oaks C.O.R.E or contracted health care to start preliminary treatment and arrange transportation for me or my child/wards to a local Emergency Room in the event that I or my child/wards become(s) ill or injured.

 

By signing this Waiver and Liability Agreement, I acknowledge that I HAVE READ AND FULLY UNDERSTAND AND AGREE TO ALL OF ITS TERMS AND CONDITIONS INCLUDING PERMISION TO TREAT AGREEMENT. I further state that I have executed this waiver and liability voluntarily and with full knowledge of its significance to be binding on my, my heirs, executors, administrators and assigns. 

Unique Waiver ID Code: WQsIRUPvCqMIvma1