Parent(s) or Guardian(s) who have been authorized by this form are the only persons staff will release the child to from the ASP( After School Program). If there is an emergency that prohibits those authorized on this form to pick up the child, we require the parent to call the Bent County Community Center front desk at 719-662-1235 to advise staff of the person receiving “one time” authorization to pick up the child. To maintain a safe process for your child we ask that this procedure only used in case of emergency.
(WAIVER OF LIABILITY & APPROVAL FOR PARTICIPATION)
In consideration of (name of child)membership and participation in the activities, special program or events at the Bent County/Las Animas Community Center, I as parent/guardian of above named minor, grant permission for participation in center activities and waives any and all rights and claims or damages against the Bent County/Las Animas Community Center and/or its sponsors for all claims arising from traveling to center and participating in activities and programs. I will on behalf of above said child assume and pay any medical or emergency expenses in the event of an accident, illness, or other incapacity. I authorize the ASP to share information with the Las Animas school district, and to take pictures of my child participating in ASP activities.
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