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Girls Middle School Off-Campus Permission - Waiver Form

I. TRAVEL TO PRACTICES TO: Queen Anne Recreation Center 1240 West Blvd, Los Angeles, CA 90019, EG Roberts Aquatic Center, 4526 Pico Blvd, Los Angeles, CA 90019, and/or Memorial Branch Library4625 W Olympic Blvd, Los Angeles, CA 90019 (“trip”)

Mode of Travel: Walking if only accompanied by parent or JMG Coach

Special Activities/ Risks include but are not limited to: Foot Travel at location, Exposure to unfamiliar city or large crowds, Exposure to weather or outdoors, etc

Precautions: Check weather before departure; Wear appropriate clothing for venue and proper footwear for walking/activities.

This is to certify that my child has full permission to, and/or has voluntarily agreed to:

Travel in a group with a parent or JMG Coach to either Queen Anne Recreation Center 1240 West Blvd, Los Angeles, CA 90019, Memorial Branch Library, 4625 W Olympic Blvd, Los Angeles, CA 90019 or EG Roberts Aquatic Center, 4526 Pico Blvd, Los Angeles, CA 90019 only in connection with a Girls Middle School Program.

II. LIABILITY WAIVER / RISK ACKNOWLEDGEMENT:

I understand that participation in trip activities could involve risk of physical injury, illness, death or property loss, and despite safety precautions, the university cannot guarantee safety thereof, as all risks cannot be prevented. JMG Inc, does not provide health and accident insurance for trip participants, and I understand that any medical expenses, property loss, or other personal expenditures that result during or from this travel/trip, are to be borne by the student/participant, or by their parent or guardian (if student/participant is a minor). I also hereby consent, give authorization to, and release from liability; trip leaders to secure any emergency medical treatment in event I am unable to, and I agree to be responsible for the costs thereof.

I further acknowledge that if I drive my own vehicle, or am a passenger in another’s private vehicle in connection

with this trip/function, that JMG INC’S auto insurance does not cover such a private vehicle. I also understand that JMG INC cannot be responsible for assuring the safety and reliability of such private transportation or driver, nor for any non-sponsored activities and travel that I/my child might choose to participate in before, during or after the JMG sponsored function, and I therefore accept the risks and responsibilities associated with such private vehicle travel and activities.

In consideration of the opportunity afforded, with full knowledge and acceptance of the risks associated with this trip and any recreational activities noted within; and with full understanding of the above issues/conditions and risks, I hereby release, indemnify and hold harmless JMG., Inc, its faculty/staff, trustees, officers, volunteers, and agents from all form and manner of risks inherent in, and from all claims, suits and demands of any nature arising from participation in said trip, or activities.

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November 11, 2016 5:21 pm PDT

Girls Middle School Off-Campus Permission - Waiver Form Uploaded by Matthew Wong - jmgsoccerclub@gmail.com IP 38.13.18.37