To Parent or Guardian
From: Jr. High Student Government
Re: Cantine Haunted Estates Dance
Date: September 9, 2014
The Jr. High Student Government is having a Cantine Haunted Estates Dance at Puttin Plus on Friday, September 26, 2014 from 7:00 pm-10:00 pm (Rain date Oct. 3rd). The fee for the dance is $13.00 (Our special school price is a bargain). Dance admission includes the DJ and either one 25 minute Cantine Haunted Estates Tour (less if you are running!) OR one Go Kart ride. If you would like to attend, please fill out the permission form and return it to your homeroom representative, Mrs. Van Voorhis as soon as possible.
Additional Go Kart rides or Cantine Haunted Estates tour tickets may be purchased for $6.00 during the dance from ticket booth on site.
Special Instructions: Individual student participation in this activity must be approved by teachers and administrators. Only students in good standing can participate. All school rules and Puttin Plus- Cantine Haunted Estates rules are in effect. Anyone not following rules will not be allowed to participate. The Rules and Regulations for Puttin Plus-Cantine Haunted Estates are on the back side of the permission slip. In addition, all rules for Puttin Plus can be found on the Puttin Plus Web-site.
Please return the signed permission slip to Ms. Van Voorhis (room 500) or to your homeroom representative by Tues, September 23, 2014.
What to Bring:
· Appropriate dress: Dress for OUTSIDE Weather
· No skirts on Go Karts
· Good Manners, all school rules apply
· Money for snack bar
· Suitable footwear for walking on different surfaces
SAUGERTIES JUNIOR HIGH SCHOOL
Saugerties, New York
Jr. High Student Government Field Trip Permission Form
GENERAL INFORMATION
Date of Trip: Friday, September 26, 2014 (Rain date Oct. 3rd )
Destination: Dance at Puttin Plus
Class/Club: 7th & 8th grade Student Government
Teacher/Advisor: Ms. Van Voorhis
Starting Time: 7:00 PM at Puttin Plus, Washington Ave. Ext.
Pick up Time: 10:00 PM - Pick up at Puttin Plus, Washington Ave. Ext.
Purpose of Trip: Jr. High Student Government Fun Activity & Dance
Special Instructions: Individual student participation in this activity must be approved by teachers and administrators. Wear suitable footwear for walking on different surfaces and dress for Outside Weather.
Cost of Trip: $13.00- check payable to: Jr. High Student Gov.
PARENT/GUARDIAN (S)
I give permission for my son/daughter, _________________________Grade ___ Homeroom #____
(must have #)
to attend the Cantine Haunted Estates Dance. I am aware that all school rules and regulations applicable at school remain in effect during the field trip. I have read and understand the Rules and Regulations for Puttin Plus on the reverse side and agree to follow them.
Medication(s):_____________________________________________________________________
Check # ________ Cash_________
In the event of a medical emergency, if every effort to contact me is taken and I can’t be reached,
I give my permission to medically treat my son/daughter.
______________________________________________ _________________
(Parent/Guardian signature) (Date)
Home Phone # ______________________ Contact Person_______________________
Emergency
Phone Number: ______________________ Contact Person_______________________
Rules and Regulations for Puttin Plus
A Halloween haunted Family Fun Center where all areas
have been converted to give you a special scare –
Our Haunted houses are unique!!!
The Cantine Haunted Estates is a weather related facility,
partially performed outdoors . We cannot control the weather.
It is important for you to know there are no refunds.
Most of the attraction is performed in the dark.
Appropriate attire is required for uneven walking surfaces,
low visibility, fog, damp and or wet conditions may be present.
In addition strobe lights, audio and visual distractions
took us months to prepare.
You should not participate if you are:
pregnant, prone to seizures, are claustrophobic –
or if you have a heart, back or respiratory problems.
At Cantine Haunted Estates, we will make every effort to insure your safety.
Anyone not being safe will be refused entrance to the park.
Those already in the park and not being safe will be removed.
Absolutely No Refunds
Our Puttin Plus Go Kart Track will be open.
You may choose to ride a Go Kart if you do not want to take the Haunted tour.
(for an additional Go Kart rides, there is a charge of $6.00 per ticket )
We have the best Go Kart track in the Catskills.
Your admission includes the Haunt Experience OR a Go-Kart ride.
DJ for dancing.
Night time temperatures can be cool. This is an outside dance under a tent. Dress warm!
Puttin Plus Phone # 246-4501
PUTTIN PLUS INC
DBA PUTTIN PLUS FAMILY FUN CENTER
Release and Waiver of Liability and Indemnification Agreement
In consideration of being allowed to participate in the activities at this facility, the undersigned participant
hereby acknowledges that he or she understands that Go Karts / Batting Cages /Laser&Water Tag and Mini Golf are
inherently dangerous activities and participating in these activities may be hazardous. Participant assumes any and all
risks associated with his or her voluntary participation in the go karts/ batting cages/laser&water tag and mini golf and
any and all activities incidental thereto. Such risks may include, without limitation, bodily injury, dismemberment,
total and permanent disability or death.
Participant agrees, by his or her voluntary participation and use of the Go Karts/or Batting Cages, and any and
all other activities on or about these premises, and on behalf of his or her persona, representatives, assigns, heirs, and
next of kin, that he or she shall release, discharge, hold harmless, and fully and forever waive any and all claims,
demands and/or causes of action against Puttin Plus Inc, affiliate associations, local associations, and all promoters,
sponsors, agents, employees, officers, directors, representatives and/or volunteers there of (releases), from any and all
liabilities, damages, costs and expenses arising out of such participation including without limitation, and of releases'
own negligence. Participant agrees to pay for any and all damages caused by he or she,negligently,willfully, or
otherwise.
This Agreement shall be governed by the laws of New York. Any lawsuit arising under this Contract shall be
brought in the appropriate Court in the Judicial District of Ulster County New York. If Puttin Plus Inc must seek legal
action to enforce this agreement or defend an action which involves this agreement, then Puttin Plus Inc . Shall be
entitled to attorney's fees and costs associated therewith.
Participant grants to Puttin Plus Family Fun Center to utilize his or her name and/or image or likeness incidental to any promotional activities related to its facility, events and/or activities.
Participant further agrees that he or she will abide by any and all rules and regulations Puttin Plus Inc reserves the right to revoke all rights and privileges pertaining to participant's involvement in, or related to, its activities.
In signing the foregoing Release and Waiver of Liability and Indemnity Agreement, I acknowledge andrepresent:
• That I have read the foregoing Release and Waiver of Liability and Indemnity Agreement. Understand it, and sign voluntarily.
• I am at least 52” tall, and 8 years old to drive a single Go Kart . To drive a double Go Kart I am 16 yrs old.
• I am not pregnant, and have not consumed alcohol or drugs which may affect my ability to participate in a safe manner on Go Karts, Batting, Mini Golf ,Laser Tag, Water Tag, the Arcade or any other activities.
• That I do not suffer from a heart condition, high blood pressure, back ,neck or other skeletal problems, or other medical conditions which may be aggravated by my participation in this activity.
• That I have taken notice of and will obey all rules and regulation of Puttin Plus Inc.
• I take full responsibility for any injuries I may incur while on the property at 455 Washington Ave Ext. Saugerties, NY 12477
Printed Name(student): ________________________________________________________________________
Signature(parent):__________________________________________________DATE______________________
************************************************************************************************************************************
*if the signatory to the above agreement is under 18 years of age then the following shall be completed:
ADULT/GUARDIAN CONSENT (if driver is under 18 years)
In my capacity as parent/guardian, I (full names)_____________________________________of
(address)_______________________________________________________________________
(relationship)_________________________________________, hereby warrant that I have the authority to execute
this release and indemnity agreement on behalf of the undersigned driver, and hereby approve and consent the driver
to participate in operating a Go Kart. I accept liability individually and on behalf of the undersigned driver and
for any injuries he/she may incur while Batting, Mini Golf, Lazer/Water Tag ,Arcade or just by being on the property
of Puttin Plus at 455 Washington Ave Ext, Saugerties, NY 12477.
Signed:__________________________________________________________Date:___________