St. Andrew’s Church & School Dance Permission and Participation Agreement
To be eligible to participate in St. Andrew’s Dances students must be an active (2024-2025) school year middle school student (private school, public school, or homeschool) in the 6th-8th grade. Further, both parent and student understand any violation requiring dismissal from a dance will result in revocation of the student’s Dance Permission and Participation Agreement and disallow any future dance attendance.
RELEASE OF ALL CLAIMS: (INJURY RISKS, EMERGENCY MEDICAL, CODE OF CONDUCT) PARENTS OR CHILDREN WHO DO NOT WISH TO ACCEPT THE RISKS DESCRIBED IN THIS WARNING SHOULD NOT SIGN THIS Permission and Participation Agreement: By its nature, Participation in student activities includes risk of injury that may range in severity from minor to disabling to even death. Although serious injuries are not common in supervised student activities, it is impossible to eliminate the risk. Participants can and have the responsibility to help reduce the chance of injury. Participants must obey all safety rules.
I have read the above warning and release and understand its terms. I understand that all student activities can involve RISK OF INJURY, including, but not limited to, those risks outlined above. In consideration of St. Andrew’s Church & School permitting my child to participate in the activity I hereby agree to hold St. Andrew’s Church & School, collectively and individually, its employees, agents, representatives, medical personnel and volunteers harmless from any and all liability, actions, caused of actions, debts, claims or demands of any kind and nature whatsoever that may arise by or in connection with participation of my child/ward in this activity. This includes all claims based on negligence. The terms hereof shall serve as a release and assumption of risk for my heirs, estate, executor, director, and assignees and for all members of my family.
By signing this Permission and Participation Agreement, we acknowledge that we have read the above information. “I hereby give my consent for the below named participant, 1. To participate in the student activities described above, 2. To receive, through a medical doctor of the Program Director’s choice, emergency medical care that may become reasonably necessary in the course of such activity. I further agree not to hold St. Andrew’s or anyone acting in its behalf responsible for any injury occurring to the below named participant in the proper course of such activities.”
EMERGENCY INFORMATION AND MEDICAL TREATMENT CONSENT: In emergency, contact the parent or legal guardian as indicated on this form. I as the parent or guardian of the participant below recognize that as a result of activity participation, medical treatment on emergency basis may be necessary and further recognize that the St. Andrew’s Staff may be unable to contact me for my consent for emergency medical care. I do hereby consent in advance to such emergency care, including hospital care, as may be deemed necessary under the existing circumstance.
PUBLICATIONS: I hereby give St. Andrew’s Church & School permission to use my child’s photograph from the dance on their website or social media accounts.
CODE OF CONDUCT: 1. Participants will remain inside designated dance boundaries during the dance. 2. Participants will obey the requests and instructions of all St. Andrew’s staff and volunteers: chaperone, dance monitor, site monitor, security person or any St. Andrew’s person-in-charge. Failure to do so will be deemed a violation of the Code of Conduct. 3. Abusive language and/or actions used toward any participant or adult will not be tolerated and is cause for immediate dismissal. 4. Clothing may not have any reference to drugs, tobacco, alcohol, sex, gangs and may not be unchristian in nature. Shorts and skirts will be modest with regard to tightness and length. NO Short shorts, NO mini skirts, and NO bare midriffs will be allowed. If clothing is found to be objectionable, a call will be made to parents to either pick up the child or bring appropriate clothing. 5. There will be no inappropriate dancing or public displays of affection. 6. All dance participants are minors. Therefore, no inappropriate age-related activity will be permitted. 7. Participants will not bring any outside beverages, including personal water bottles to the dance. The contents of all beverage containers will be disposed of prior to entry to the dance. Violations may result in dismissal from future dances.
RESPONSIBILITY: Parent/Guardian must sign the waiver and complete the payment for a student to attend. *Complete address, Participant and Parent/Legal Guardian signature are mandatory for this agreement to be valid A) Participant
