Parent S Approval, Student Waiver and Confirmation: Please Read Through

PARENT’S APPROVAL, STUDENT WAIVER AND CONFIRMATION: PLEASE READ THROUGH

(This is your only confirmation document, please make a copy for your records.)

______has my (our) permission to participate in ______

______for the fee of______. (see below for payment information)

The undersigned parent or guardian agrees to, certifies and acknowledges the following:

·  Parent or Guardian assumes all risks in connection with the student’s participation in any and all Maryland PTA/Pyle Middle School PTSA sponsored activities.

·  The Maryland State PTA, Pyle Middle School PTSA, all PTA officers, employees and agents are released and discharged from all liability for any damage, loss or injury to the student, the student’s property, or parent’s property in connection with participation in these activities, unless caused by the negligence of the PTA. In addition the Maryland State PTA, Pyle Middle School PTSA, or instructors of the activities are not responsible for the student once they leave the school property after the scheduled activity.

·  Parent or guardian assumes all responsibility for informing the instructor of the above-registered activity, that the above-named minor has any allergies, medical reactions or unusual physical condition which should be made known to a treating physician or which could limit participation.

·  Please also list here allergies, medical reactions or unusual physical conditions for the Panther Program’s administrator records. This list is not seen by the instructor, again informing the instructor is the responsibility of the parent or guardian.

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If none please write “none”

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Signature Date Print Name

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Address City Phone

NEW PAYMENT INSTRUCTIONS: PLEASE READ!!

1.  One check per activity registered for with activity name on memo line (eg. If you sign up for two activities you must send two checks with proper designation of activity.

2.  Make check(s) payable to Pyle PTSA only.

3. All payments and signed registration forms should be mailed to Dona Squeri at 5121 Westpath Way, Bethesda 20816. If the student does not make payment and/or send registration forms by the deadline there will be ONE reminder email sent to the address given on the registration site.If the student does not have the payment and/or the registration forms by the start of the first class, they will be asked to leave the program and their name will be dropped from the roster.

Please if you have any questions regarding payment or proceedures.