Parental Permission to Participate

Please read the Parental Permission to Participate below, then check the certification box on the Trip Reservation Form.

I have given my child permission to participate on this voluntary overnight trip and all travel and activities associated with it.  I understand that my child’s participation on the trip is not mandatory.  I acknowledge that I have had the opportunity to ask questions and obtain whatever information I require to fully inform myself about the trip.  I am satisfied as to the adequacy and safety of the arrangements for the trip. 

In the case of a trip involving travel to a foreign country, I have had the opportunity to review information about the foreign country to which my child will be traveling (including information about any required and/or recommended vaccinations, medications and/or other protective measures that should or can be taken when traveling to the foreign country) provided by the State Department (http://www.travel.state.gov), the State Department Consular Information Sheets (http://travel.state.gov/travel/cis_pa_tw/cis/cis_1765.html), and the Centers for Disease Control (http://www.cdc.gov/travel). 

I am also familiar with the mental and physical health of my child and his ability to travel to unfamiliar places and be exposed to people of different ethnic, cultural, and linguistic backgrounds.  My permission for my child to participate on the trip is based upon my belief that he has the maturity and self-confidence to be able to respond appropriately to any challenges which he may encounter during the trip.

 

Parental Release, Assumption of Risk and Indemnification Agreement

Please read the Parental Release, Assumption of Risk and Indemnification Agreement below, then check the certification box on the Trip Reservation Form.

In consideration of my child being permitted to participate on this voluntary overnight trip, I forever release, acquit, discharge, covenant to hold harmless and covenant not to sue Belmont Hill School (the “School”), its trustees, employees, representatives and agents from any and all claims, suits, liabilities, actions and causes of action which I or my child or our heirs, legal representatives, successors and assigns may have, now or in the future, which arise directly or indirectly out of my child’s participation on the trip.

I hereby agree to indemnify the School, its trustees, employees, representatives and agents from and against any and all claims, suits, actions, causes of action, and liabilities, including attorneys’ fees, resulting directly or indirectly from my child’s participation on the trip, including but not limited to injury of any person caused by my child or for damages to or destruction of any property caused by my child.

I have reviewed the plans for the trip and recognize and appreciate the risks and danger associated with my child’s participation on the trip, including but not limited to risks associated with air travel, surface travel, staying in living situations that are not always well known, attending school in a foreign country, living with a host family, and participating in the daily activities of the trip.  I hereby assume the risk of any and all losses and damages, including but not limited to personal injury, which my child may incur as a result of participating on the trip.

I recognize that general social and political conditions and circumstances may affect the trip and are outside the School’s control and have agreed, with knowledge of those conditions and circumstances, to allow my child to participate on the trip and to assume the risks that I am assuming by this agreement.

Parents’ Financial Responsibility and Warranty of Insurance

Please read the Parents’ Financial Responsibility and Warranty of Insurance below, then check the certification box on the Trip Reservation Form.

I understand that Belmont Hill School (the “School”) may make financial commitments based on my child’s commitment to participate on this voluntary overnight trip.  For this reason, I will be responsible for the total cost of the trip, whether or not my child participates in it.  Neither I nor my child will have the right to a refund of any monies paid or owed for the trip, including but not limited to monies paid for accommodations, meals, transportation, and activities. 

I understand that the School reserves the right to increase the price of the trip by the amount of any increase in costs including, without limitation, increases in air carrier tariffs, rates of currency exchange, incidental costs, and applicable government taxes.  I agree to pay any such increase in price and understand that I am not entitled to cancel the reservation of my child or receive a refund on the basis of any such increase in price.

I understand that the School reserves the right to cancel or reschedule the trip up to and including the time of the scheduled departure and to recall any trips in progress for any reason deemed appropriate by the School. Should the School cancel or reschedule the trip after monies have been paid, I understand that the School will make a good faith effort to obtain reimbursement of such monies.  However, I understand and recognize that the School, its trustees, representatives, agents and employees are under no obligation to provide reimbursement of any amounts paid.  I agree to forever release, acquit, discharge, covenant to hold harmless and covenant not to sue the School, its trustees, employees, representatives and agents for any financial losses I or my child may incur in connection with any cancellation or rescheduling of the trip.

Medical Treatment Authorization

Please read the Medical Treatment Authorization below, then check the certification box on the Trip Reservation Form.

I recognize that in rare instances a medical, dental or surgical emergency requiring treatment arises in which written consent by parents or guardians is legally required, but the parents or guardians cannot be reached.  In this event, and in order to avoid delay that might jeopardize the life or recovery my child, I do hereby appoint Belmont Hill School (the “School”), trip chaperones, host families or host schools my true and lawful attorney for the purposes of taking all steps necessary to ensure the proper care (including but not limited to medical, surgical, dental and hospital care) of my child while he is away from home and participating on the voluntary overnight trip, and to execute any and all necessary documents and papers requested by any person prior to treatment of or rendering of care to my child. 

I understand that the School, trip chaperones, host families or host schools will, to the extent possible, consult with me concerning the reasons for and effects of all such care.  Recognizing that it may be difficult to reach me, I authorize the School, trip chaperones, host families or  host schools to permit commencement of treatment when, in the professional judgment of the physicians, dentists or other medical personnel involved, such treatment is medically necessary, even if I have not yet been consulted.  In authorizing such emergency treatment, I agree to accept the determination of the treating physician, dentist or other medical personnel that the treatment or care rendered was medically necessary to protect the life, health or mental well-being of my child.

 

Transportation Waiver

Please read the Transportation Waiver below, then check the certification box on the Trip Reservation Form.

I understand that students are expected to travel in transportation arranged by Belmont Hill School (the “School”) to and from the destination of the voluntary overnight trip.  Even though I have been informed and understand that the School will provide such transportation, I may decline the use of such transportation and waive any privilege or right my child may have to use such transportation in connection with the trip.  In such case, I will make the request in writing to the faculty member in charge of the trip and receive his/her written approval in advance of the trip’s departure. 

In requesting such waiver I understand and agree, individually and on behalf of my child, that the School, its trustees, employees, representatives and agents assume no liability, responsibility and will not otherwise be held accountable for either the means or safety of the transportation authorized by me for transporting my child in connection with the trip.  I further voluntarily agree to indemnify, hold harmless and release from liability the School, its trustees, employees, representatives and agents from any suit, demand, injuries, damages, or claims for damages of any form or description arising or said to arise out of the use of any non-School arranged transportation which I specifically authorize.