After School Sports (K-5) / Session I
“SNACkTIVITY” for September 2015 (K-8)
DAILY SCHEDULE: 3:45 – 5:15 (5 week session)
MONDAY (Aug. 31, Sept. 21): Hockey in the gym
TUESDAY (Sept. 1, 8): Basketball in the gym
WEDNESDAY (Sept. 2, 9, 16, 30): Flag Football in the backfield
*THURSDAY (Sept. 3, 10, 17, 24, Oct. 1): Water polo & other pool games
FRIDAY: (Sept. 4, 11, 18, 25, Oct. 2): CAPTURE THE FLAG in the backfield
COST: $26 (Monday only = $13/day)
$26 (Tuesday only = $13/day)
$52 (Wednesday only = $13/day)
$65 (Thursday only = $13/day) *Certified life guards will be on duty
$65 (Friday only = $13/day)
$180 (ALL SESSIONS: Monday, Tuesday, Wednesday, Thursday and Friday: $10/day)
OR PAY DAY-BY-DAY ON THE DAYS YOU DESIRE TO ATTEND
½ HOUR WILL BE DEVOTED TO SNACK (healthy --- I provide) AND HOMEWORK THEN THE SPORT OF THE DAY, PICK UP CHILDREN AT BACK ENTRANCE (gym) OR AT POOL on swim days.
CASH or CHECKS payable to Marla Rosin-Borrousch (Absenteeism does not change fees)
Call or text @ 904-315-5485 or e-mail
**NO AFTER SCHOOL SPORTS ON EARLY RELEASE AND HOLIDAYS**
E-Mail: ______Child’s Name: ______
ANY Known Food Allergies of Child: ______
Name of grown-up legally responsible for child: ______
(First Name) (Last Name)
Cell Phone: ______Home Phone: ______Work phone: ______
I have read and understand the payment schedule, procedures & “Waiver, Release and Hold Harmless Agreement” for the After-School Snack, Study and Sports program at Galinsky Academy, MJGDS and JJC.
______
Signature of parent enrolling child Date
Waiver, Release & Hold Harmless Agreement For the After-School Snack, Study and Sports Program at GAlinsky Academy and MJGDS and JJC
I, the undersigned, affirm that my named child, ______,
is a participant in the After-School Study, Snack and Sports Program at the Galinsky Academy, including the Martin J. Gottlieb Day School (“MJGDS”) and the Jacksonville Jewish Center (“JJC”) and, on behalf of my minor child I do represent, covenant, and agree, on behalf of myself, my child and my child’s heirs, assigns, and any other person claiming by, under, or through my child, as follows: I acknowledge that participating in the above noted activity involves certain risks (some of which I may not fully appreciate) and that injuries, death, property damage or other harm could occur to my child or others. I accept and voluntarily incur, on behalf of my child, all risks of any injuries, damages, or harm which arise during or result from my child’s participation in the Activity, regardless of whether or not caused in whole or in part by the negligence or other fault of Galinsky Academny, MJGDS and the JJC and Marla J. Rosin-Borrousch, and/or its or their departments, trustees, affiliates, employees, officers, agents or insurers (“Released Parties”). In exchange for this waiver on my part, the Released Parties agree to exercise due diligence in providing as safe of an environment for my child as the circumstances allow and will provide adequate supervision and instruction for my child during the program time.
.
I, on behalf of my child, waive all claims against any of the Released Parties for any injuries, damages, losses or claims, whether known or unknown, which arise during or result from my child’s participation that may be associated with the Activity, regardless of whether or not caused in whole or in part by the negligence or other fault of any of the Released Parties. I, on behalf of my child, release and forever discharge the Released Parties from all such claims. The parties agree that this agreement does not waive or release any rights I or my child may have under Florida law governing workers’ compensation. I, on behalf of my child, agree to indemnify and hold the Released Parties harmless from all losses, liabilities, damages, costs or expenses (including but not limited to reasonable attorneys’ fees and other litigation costs and expenses) incurred by any of the Released Parties as a result of any claims or suits that I (or anyone claiming by, under or through me or my child) may bring against any of the Released Parties to recover any losses, liabilities, costs, damages, or expenses which arise during or result from my child’s participation in the Activity, regardless of whether or not caused in whole or in part by the negligence or other fault of the Released Parties.
I have carefully read and reviewed this Waiver, Release & Hold Harmless Agreement. I understand it fully and I execute it voluntarily on behalf of myself and my child.
EXECUTED this ______day of ______, 2015
______
Parent or Guardian Signature
Parent/Guardian Printed Name