B7-OFF-SITE PERMISSION
B7-OFF-SITE PERMISSION
Select Youth Group Below
*
Delta GEMs
Delta Academy
EMBODI
DEEP
Cotillion
OFF-SITE PERMISSION
I, _______________________________________, as Parent or legal Guardian, give permission for
_______________________________________ to participate in the Chapter’s Youth Initiatives
Program’s (the “Initiatives”) activities taking place off-site. I understand that transportation to and from these activities will be provided for my Child by the Chapter.
I understand that the field trips are part of the Initiatives and if I choose to not have my Child participate in one or more off-site activities, I must make other care arrangements for my/our child during the times of that field trip activity.
I assume all risks and hazards of loss or injury of any kind that may arise in connection with such trips, except for gross negligence or intentional infliction of harm by the Initiatives, its officers, agents, or employees.
I do hereby agree to release and hold harmless the Initiatives, Delta Sigma Theta Sorority, Incorporated (“Delta”), its officers, National Executive Board, employees, members, representatives, agents and assigns from any and all claims, costs, suits, actions, judgments, and
expenses for any damage, loss, or injury to my/our child or damage to my/our child’s property arising from my/our child’s participation in field trips, other than damage, loss, or injury that results
from gross negligence or intentional infliction of harm by the Initiatives, Delta, its officers, National Executive Board, employees, members, representatives, agents and assigns.
Parent/ Guardian Name
Parent/ Guardian Name
*
First
Last
Participant Name
Participant Name
*
First
Last
Parent/ Guardian: Draw your signature into the box below.
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Date
Date
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MM
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DD
YYYY
Submit