All Posts
×
Parental Consent Form I, the undersigned, acknowledge that, as with all activities, there are some inherent risks of minor injury or accidents while participating in our courses. As such, in consideration of my child’s participation, on behalf of my self and/or my child, hereby release, discharge, covenant not to sue, and agree to indemnify and hold harmless Dexter Learning Company, employees, other participants, and the owners and lessors of the premises on which activities take place from any and all liability, claims, and causes of action arising out of or related to any loss or injury, that may be sustained by myself or my child, whether caused by the negligence or otherwise while participating in such activities, or while in, or upon the premises where the activity is being conducted. Dexter Learning is not licensed by the State of Texas Medical Care I, the undersigned, further give my permission for any emergency medical care or treatment by a physician, surgeon, hospital, or medical care facility that may be required, including transportation, and accept responsibility for the cost. I have read and understand the statement contained above and intend for others to rely on this representation. I, the undersigned, authorize staff/volunteers of Dexter Learning Company, in whose care the minor has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment, and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any licensed physician or dentist or the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization. Media By signing below, you grant Dexter Learning the sole and unrestricted right to all images, testimonials, photos, video, and audio taken of aforementioned child while at Dexter Learning facilities and events, for use in Dexter Learning publications, printed or digital, as well as on Dexter's website and/or social media sites.