PARENTAL CONSENT & WAIVER CBEA-C-CHILD CARE SERVICE
Child’s / Children’s name/s :
I / We, the undersigned, are the parent(s) / guardian(s) of the above – named child / children and hereby consent to the participation of the child / children in all activities and attractions of and within CBEA-C-CHILD CARE SERVICE(C-CHILD CARE) for which the child / children meet/s. The children that participate in activities with C-CHILD CARE are consistently well supervised. However, I/ We recognize that accidents do happen. The undersigned assume/s all risk of injury or harm to the child associated with participation in C-CHILD CARE’s activities and agrees to release, indemnify, defend, and forever discharge C-CHILD CARE and its staff, employees, and agents from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect of injury, viral infection,accidents and incidents whilst child’s pickup and drop-off, loss, damage or death to the child,howsoever caused, arising by reason of or during the child’s participation in C-CHILD CARE.
In the event my child / children need/s medical attention for injuries while at C-CHILD CARE, I authorize the C-CHILD CARE staff to give my child / children First Aid and will first use reasonable efforts to contact the parent(s) or guardian(s) before administering or authorizing any treatment and provide proper transportation to a health care facility if needed and fully release C-CHILD CARE and its employees, staff, and agents from any liability.
I hereby grant permission for C-CHILD CARE and its employees full authority to take whatever actions they deem necessary regarding my child’s health and safety in the event I cannot be reached or in the situation where time is of the essence; and fully release C-CHILD CARE and its employees, staff, and agents from any liability in connection with those decisions, I grant permission for emergency treatment by a rescue squad, private physician and/or hospital or emergency health care facility staff if needed. Accidents (sickness and viral infection are excluded from the coverage) will only be covered within the warranty scope of coverage by the insurer. Any such action will be taken in the best interest of my child and will be reported to me as soon as possible.
I HAVE READ AND UNDERSTAND THIS ON-SITE CONSENT AND WAIVER FORM AND SIGN VOLUNTARILY AND ENTIRELY OF MY OWN FREE WILL.
- Parent/Guardian name & signature
- Date
Members: The agreement is valid for one year.
- Date Enrolled:
- Valid until:
Non-members: Required to sign the waiver each time when depositing a child.