I, the undersigned, as the parent or legal guardian of ____________________________________________

Do hereby give my full consent and approval for my child to participate in all activities at 1

Class After Class

Before and After School programs in classrooms, gyms and school/program playgrounds.

I understand that there are certain risks of damages and injuries inherent in the participation of my child in

these activities and I hereby accept these risks on behalf of my child.

I understand that it is my child’s responsibility to abide by the rules and regulations imposed on the children

by the Program Educators for the safe conduct of activities in the gym and on the playground.

I hereby, for myself and on behalf of my child, agree to save and hold harmless and fully indemnify 1

Class

After Class management and sta from any and all liability for any personal injury or injury to any third party

child resulting from my child’s participation in the above mentioned activities.

I hereby release 1

Class After Class and its entire sta from any and all liability for any injuries that my child

may sustain as a result of any activities that take place at 1

Class After Class Classroom/Gym and school/pro-

gram playground during designated childcare hours.

I have received and read the 1

Class Parent Handbook in full and fully understand the policies and proce-

dures entailed in the handbook and understand my requirements regarding my child(ren).

I also give consent to receive electronic messages from 1

Class including Program updates, important info

and emergency communications.

ACKNOWLEDGEMENT AND RELEASE OF LIABILITY FORM

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Parent / Guardian (1) Printed Name Parent / Guardian (2) Printed Name

Date Signed Date Signed

x x

After Class

& Preschool