Fill and Sign the Parent Affidavit Form

Parent's Affidavit and Agreement Giving Consent to Educational Tour of Minor I, ________________________________________________ (Name of Parent) , a parent (or legal guardian) of ______________________________________________ (Name of Minor) , a minor who is a student at __________________________________ ______________________________________________ (Name of School) , (said minor being hereinafter called Student ), which is located at _____________________________ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code) , in consideration of the agreement by the school to permit Student to participate in the educational tour to ________________________________________________________ ___________________________________________________ (destination of tour), to take place from ________________________________ ( date) to _____________________________________ (date) , state under oath that there is accident and health insurance coverage for Student that will cover Student while participating in the trip, and that I agree to maintain coverage in full force and effect for the duration of the trip. I do further agree to indemnify, protect and hold harmless the school, its officers, board members, supervisors, agents, servants, employees, and all private persons or organizations volunteering services without charge to supervise or chaperon students while on the educational tour from any claim or liability whatsoever, including, but not limited to, personal injury, property damage, court costs, attorney's fees and interest, however caused, as a result of Student participating in the educational tour. I do further agree that the board of education, its officers, agents, and/or employees reserve the right to terminate the participation of the Student for failure to behave and act in accordance with the school's regulations on conduct, for failure to follow the instructions and directions of the tour supervisor and chaperons, or for any acts of conduct of the Student deemed by the board, its officers, agents, or employees, to be detrimental to or incompatible with the interest, harmony, comfort or welfare of the tour as a whole. If the participation of the Student is terminated, only the funds not actually used will be refunded, and Student will be sent home at my expense. I agree that the board of education, the school, its officers, agents, and employees reserve the right at any time prior to or during the tour to make cancellations, changes or substitutions in emergencies or changed conditions or in the interest of the group, and to alter, prior to tour departure, the cost in order to meet unexpected changes in airline fares, hotel rates, etc., as the announced fee is based on current tariffs, rates, and expenses which are subject to change. Witness my signature this the _____ day of _____________________________, 20____. ______________________________ Name of Parent STATE OF _________________________________ COUNTY OF ______________________ Personally appeared before me, the undersigned authority in and for the aforesaid jurisdiction, the within-named ______________________________________________ (Name of Parent) , who, after having been first duly sworn by me, stated on oath that the matters and facts set forth in the above and foregoing instrument are true and correct as therein stated. ______________________________ Name of Parent SWORN to and subscribed before me, this the ___ day of ____________________________ _ ____, 20____. ________________________ _____ Notary Public My Commission Expires: