JC indemnity renew

RENEW INDEMNITY AND WAIVER

Please read the indemnity as completing the form is taken as acceptance

PERSON TO CONTACT (in case of emergency)

Name

First Name

Last Name

Phone

(###)

###

####

Information regarding minor child

Name

First Name

Last Name

Grade and Age

Allergies

Please be advised that if your child is on any medication, this is not the responsibility of the teacher to administer