Poway Unified School District

Mesa Verde Middle School Career Day ~ Kangas/Milling 8th grade Humanities

 

I, (full student name) _________________________, have voluntarily decided to participate in the Career Day activity below, and have my parent permission to do so.  On this day, I will shadow my sponsor (or an employee of the sponsor) for at least four hours at the work site, observing the working environment and participating as much as my sponsor deems appropriate.   I am responsible for arranging transportation to and from this location.

 

Date of Activity: ________________________________________________

Name of Sponsoring Company/Organization: ______________________________________________________________

Street Address: _________________________________________________

City:________________ Zip Code: _________ (Required for written correspondence.)

Sponsor’s Name: ______________________________________________________________

Phone Number and/or Email: ______________________________________________________________

 

1.  Acknowledgement of Voluntary Participation:  I, and/or participant, understand and acknowledge that my participation is not required by the School or District, and that I voluntarily choose to participate.

 

2.  Assumption of Risk: I, and/or participant, understand and acknowledge that in order to participate in this activity I agree to assume liability and responsibility for any and all potential risks that may be associated with my participation therein.

 

3.  Release from Liability: As parent or guardian, and on behalf of participant, I hereby voluntarily release, discharge, waive, and relinquish any and all claims or causes of action against the Poway Unified School District, the sponsor, and the sponsoring organization that may arise from any activities related to my Career Day visit.  

Signatures below indicate acceptance and verification of the above information. Completed form must be returned to Mesa Verde Middle School.  [Fax (858) 538-8636]

Student’s signature:
______________________________________________________________
Parent’s signature:
______________________________________________________________
Sponsor’s signature:
______________________________________________________________