Highmark Charter School Clinic Release Form
I hereby recognize and acknowledge that
participation in recreational activities may involve bodily injury to my child
and others. In consideration of my child being permitted to participate in this
clinic, I hereby voluntarily and knowingly execute this release with the intent
of binding myself, the above named minor, and any others having an interest,
and do hereby expressly release, waive and discharge all liability or claims
therefore resulting from my childs participation in the above clinic.
2. I hereby consent to my childs
participation in this clinic, including transportation, as appropriate, and do
further authorize the Highmark Charter School and clinic staff to act on behalf
in accordance to their best judgment in the case of an emergency and do agree
to assume full responsibility for all medical expenses that may arise there from.
By signing this document, I acknowledge
that I have read its content and disclosures, that I understand them, and that
I agree to the terms hereof. I further acknowledge that this release in
intended to be broad and as inclusive as may be permitted by the laws of the
State of Utah, and that is any portion here from is found to be invalid, it is
agreed that the balance shall continue in full force and effect.