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ACSC Insurance Verification and Waiver

Please complete the form below. Required fields marked with an asterisk *

Student First Name*

Answer required for "Student First Name"

Student Last Name*

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School*

Answer required for "School"

Grade*

Answer required for "Grade"

I hereby give my child permission to participate in the extracurricular athletic/recreational programs sponsored by the Anderson Community School Corporation (ACSC). I understand that by granting such permission that my child and I assume the risk for injuries which result from such participation. I agree to hold the Anderson Community School Corporation harmless from any and all liability which might arise due to my child’s participation in extracurricular athletic/recreational programs save for reasonable care and supervision by the agents of the school corporation.

Parent/Guardian First Name*

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Parent/Guardian Last Name*

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Signature*

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Confirmation Email

Confirmation Email *

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