Student Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Cell Phone *

(###)

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Emergency Contact Name *

(Other than yourself)

First Name

Last Name

Emergency Contact Phone *

(Other than your own)

(###)

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Permission and Release of Liability *

I acknowledge, that I am the parent/guardian of the above-named student at Annunciation Day School in Atlanta, Georgia. I give my permission for my child to carpool with employees, volunteers, or parents of other students of Annunciation Day School during the 2024-2025 school year to participate in scheduled athletic events at local area schools and facilities. I understand and do assume the risk with respect to my child carpooling to the Annunciation Day School athletic events. I understand that my child is not required to participate in this activity. I hereby agree on behalf of myself, my child’s other parent, and my child to release and hold harmless the Annunciation Day School and the Annunciation Greek Orthodox Cathedral of Atlanta, and each of their employees, officers, directors, volunteers, agents, and parents of Annunciation Day School students from any and all claims, actions, liabilities, damages, and expenses, including attorneys’ fees, with respect to any accident, injury, death, or loss of property involving my child or any other individual that occurs during or as a result of my child’s carpooling to Annunciation Day School athletic events by any of the aforementioned individuals, all to the fullest extent permitted by the laws of the State of Georgia. I read this document carefully and understand its contents.

Signature *

I understand that checking this box and providing my name below constitutes a legal signature.