Nutcracker Permission Form – Headwaters Academy

Activity: Nutcracker Student Performance

Description: Our 1st Grade class will be traveling to the High Point Ballet to see the student performance of the Nutcracker

Location: 121 S Centennial St, Suite C, High Point, NC 27260

Date: December 19th

Time: 8:30am – 12:30pm

Cost: Free

A few more details:

We will be leaving the school at 8:30am in our church vans driven by 2 qualified drivers. We will arrive approx 45 min later.

We will watch the performance at 10am and travel back to school for lunch.

Child's Name*
First Last
Emergency Contact Name*
First Last
Emergency Contact Phone*
Parent/Legal Guardian's Name*
I give permission for my child to take part in this activity.
First Last
Parent/Legal Guardian Signature*
I am fully aware that my child will be transported to and from this activity and that there will be ample supervision. I have previously completed a Medical/Liability Release Form for my child. By signing this permission slip, I am confirming that the information on his/her Medical/Liability Release Form is current and up to date. I understand in the unlikely event of an accident or emergency that my child will receive adequate care based upon the information given. I assume all risks, hazards and incidentals involved in the conduct of the activity. I do hereby release, indemnify and hold harmless Headwaters Educational Enrichment and South River Baptist Church from any and all loss, injury or other damage arising out of this activity. I understand that the child will be transported to and from the offiste activity and I also understand the inherent risks in any travel, and agree to waive any and all liability on behalf of the referenced organizations for those risks.
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