2017 MVHS SENIOR ROAD TRIP REGISTRATION & PERMISSION SLIP
Senior Road Trip 2017 will be Saturday, April 22, 2017 from 7:00 p.m. until 2:00 a.m. at Metea Valley High School. This lock-in event is hosted by the MVHS PTSA. All students attending are required to have a parent/guardian signed permission slip on file, even if the student is 18 years old. Students will NOT be permitted to leave once they have entered the party. THE MVHS code of conduct applies to this event. Coats, purses, and other personal belongings must be left at home or in the students’ cars. Students must enter the building through the athletic entrance located by the football stadium.
I hereby grant permission for my student ______to attend the Senior Road Trip and participate in all activities offered, including all use of the equipment and/or attractions offered, including without limitation, The Fun Ones Moon Jump, Inc., d/b/a The Fun Ones (“The Fun Ones”) (such activities are hereinafter referred to as the “Activities”). I waive, release, and discharge any and all claims against The Fun Ones, MVHS, the PTSA, and Indian Prairie District 204 (and their respective agents, employees, and volunteers), including any claims regarding personal injury, death, or property damage that my student may sustain or which may result from the student’s participation in the Activities. This release is intended to discharge in advance The Fun Ones, MVHS, the PTSA, and their respective agents, employees, and volunteers, of any and all liability arising out of or connected in any way with the participation of the student in the Activities. I understand that the Activities may be hazardous and include physical or strenuous exercise; that serious accidents occasionally occur during the Activities; and that participants in the Activities occasionally sustain mortal or personal injuries as a consequence thereof. Knowing the risks involved, nevertheless I agree to assume all risks of injury for such student’s participation in the Activities and to release and hold harmless The Fun Ones, MVHS, the PTSA, and Indian Prairie District 204 for any liability for damages or harm caused by or as result of such student’s participation in the Activities. I understand that this waiver, release and assumption of risk shall be binding on the heirs and assigns of the undersigned and the student.
I understand that all students must be admitted to MVHS by 8:00 p.m. If my student is not in attendance by 8:00 p.m., I will be notified by phone.
Student Name (please print)
Parent Name (please print)
Parent Signature Date
Address
Home Phone
2nd Phone Number (Emergency Contact)
Student Cell Phone Number
Student Email Address _
Parent Email Address (important for communication about the event, please print neatly) ______
Ticket Fee Enclosed: Registration fee of $50.00 is due before 3/1/17 $
Additional Donation for the event $
Contribution for the cost of registration for a student in need $
Total Enclosed (check made payable to MVHS PTSA) $
______I would like to volunteer to help with this event.
______Please do not list my child’s name on the SRT Website or public registration lists.
Completed forms and checks can be returned to school in the Senior Road Trip box located in the Senior House, or mailed to Emily Reyes, 1239 Birchdale Lane, Aurora, IL 60504.
Questions regarding registration can be directed to .
The SRT 2017 Committee regrets that no refunds can be given after the SRT registration form has been received, as we have based our games, entertainment and food contracts on our registered students, and contracts are now in place and deposits made.