» Campus Home  |  » Email Your Teacher  |  » Help  
 
    RBMS Band
   


Leander ISD Student Travel Guidelines

Parent Waiver and Release of Claims and
Consent for Medical Treatment for Student Travel
I, the undersigned parent or guardian, hereby give permission for my child or ward to participate in Band Trips/To be announced 2007-08 and involving travel by Bus.

I am aware that, should the world situation make it necessary for the administration of the LISD to cancel student travel, or if my child becomes ineligible to participate in the trip, the school district assumes no financial responsibility for any monies lost due to this action.

In regards to the above trip/activity, I release and discharge the Leander Independent School District, its employees, officers, agents and assigns from all claims which I may have or which my heirs, administrators, or assigns may have or claim to have against Leander ISD, its employees, officers, agents and assigns for all personal or property injuries caused by or arising out of the above-described trip/activity.

For the same consideration, I recognize that student participation in this trip is voluntary, and I hereby expressly assume all risk of personal injury to participant and loss or damage to property of participant or any other loss of every nature.

I acknowledge that my child or ward understands that the activity involves possible inherent risks of physical harm because of the nature of the activity itself and/or the physical environment of the location(s) wherein the activity is conducted and that it is the participant’s responsibility to use special care and caution, including but not limited to, appropriate protective apparel and/or equipment, to avoid risk of injury.

Finally, I authorize the sponsor(s) to consent to medical treatment of my child or ward in the event of medical emergency on the above-described trip.


I have read this Waiver and Release of Claims and Consent for Medical Treatment and understand all of its terms and conditions. I execute this Waiver and Release of Claims and Consent for Medical Treatment voluntarily and with full knowledge of its significance.


Student's Name:
Parent/Guardian Name
Typing your name will be considered your signature.
Parent/Guardian Address and Phone Number


Student Medical Information


Student Name
Student Birthday


Emergency Contact Name
Emergency Contact Phone

Alternate Emergency Contact Name
Alternate Emergency Contact Phone


Physician Name
Physician Phone
Important Medical Information (drug or food allergies, special medical conditions, medications, etc)


Insurance Information


Insurance Plan Name
Insured's Name
Insurance Phone Number
Group Name
Group Number
Member Number
I.D. Number
Plan Number
Additional Information


Parent/Student Agreement

Student:
I have read the Running Brushy Middle School Band Handbook and understand the requirements for being a band member of this quality organization. I realize it takes full cooperation and dedication (100% from me) to make our band meet its potential. I also realize that my failure to follow policies and directions could result in disciplinary action, which could lead to placement in another band or dismissal from the band program.
As a member of the Running Brushy Middle School Band, I acknowledge the following as responsibilities I must fulfill if I wish to remain a member. I will:
• practice with a purpose.
• demonstrate my best on playing assignments and written theory tests.
• attend all concerts and contests.
• treat my peers and teachers with respect and maintain appropriate conduct.
• maintain all of my grades for eligibility and self-achievement.
• have a high standard for improvement in class and on my own.
• demonstrate the LISD’s 10 ethical principles.

Student Name
Parent/Guardian
I have read and understand the Running Brushy Middle School Band Handbook, and plan to support it and my child. Typing your name below will be considered your signature.
Date
©2007 Leander ISD - All rights reserved.