release formTo go on an off campus De Anza Outdoor Club event, a student (or a parent/guardian for a student under 18 years old) must sign a release.
You can get a copy of the release form and fill it out in advance of signing up for a trip to make the signing up go faster.
(Sorry, you can't turn it forms or sign up for events on-line.)
Go to:
http://business.fhda.edu/risk/forms
if under 18 click on Student Fieldtrip/Excursion - Minor Authorization form and print the form
for 18 or over click on Voluntary Assumption of Risk and print the form
How to fill out the form so you won't have to do it over when you give it to the club:
MINOR:
Name of Student ... is easy enough, please print clearly.
Age: (age of the student) You must put your age or it will not be accepted by Risk Management!!
Instructor/District Representative: write in Outdoor Club
Campus: write in De Anza
at the bottom of the page where it says:
I, the undersigned certify that I am the parent or legal guardian of _____print the student's name____, as the parent or
legal guardian, I authorize my child to attend and participate in the following “excursions/fieldtrip” (dates/location):
describe the event ... examples:
ocean kayak day trip April 7, 2007 8 a.m. all day, Monterey, California
or surfing lesson, 8 a.m. to noon, Cowell's Beach, Santa Cruz May XX, 200X
or camping trip, Yosemite National Park, all weekend Feb 2-4, 200X
Don't forget the print name and sign name at the bottom
do not fill in the blanks for
Signature of Instructor/Staff Member ________ Date ____
DO print the info: In the event of an emergency, I can be reached at: (phone numbers)
18 or over:
Name of Student easy enough, print clearly
Age: you must put your age or it will not be accepted by Risk Management!!
Instructor/District Representative: print Outdoor Club
Campus: print De Anza
Dates of activity(ies), multiple dates are allowed, please be specific as to dates and purpose:
describe the event ...example: ocean kayak day trip, April 7, 200X, 8 a.m. all day, Monterey, California
at the bottom don't forget the
Signature of Adult Student and Date
don't fill in the blanks at
Signature of Instructor/Staff Member ____ Date ______
but do fill out the
In the event of an emergency, please contact: example: name, phone number, relationship to you (mom, friend, roommate?)
Bring the completed form with you when you come to sign up for the event.
Outdoor Club Coming Attractions has how to find us to sign up for events.
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