Tech Knowledge College Liability and Publicity Release Form

I certify that I am the child’s legal guardian, and I give him/her permission to participate in all scheduled activities and field trips, as indicated in the descriptions, at Tech Knowledge College 2023. I understand that there is some risk of injury to my child because the program includes interactive projects, hands-on career awareness workshops, and demonstrations provided by Moraine Park Technical College.

I agree that Moraine Park Technical College is not responsible for my child before the first session or after the second session. I am responsible for coordinating a time and place to pick up my child.

I also agree that Moraine Park Technical College is not responsible for lost or stolen items.

By signing this form, I grant Moraine Park Technical College my permission to use any and all quotations, photograph(s), videos and/or other electronic images for promotion, education and/or other purposes. I also waive any claim for financial compensation.

I also agree to hold Moraine Park Technical College, all staff participants, all facility host sites, and sponsors harmless for all personal injury, which might result from participation in any part of this program. This release applies to my child and me and our respective personal representatives, heirs and assigns.

An environment free of allergens, including but not limited to food allergens, CANNOT be guaranteed at Moraine Park Technical College. Reasonable attempts have been made and will be made to serve food not containing allergens as an ingredient, but you should be aware that Moraine Park Technical College prepares meals in a facility that uses nuts, soy, wheat, and other known allergens. Moraine Park Technical College CANNOT guarantee that any particular food product prepared, sold, bought on its campus or brought onto campus by a student or a visitor is free of all traces of any particular allergen. Nor can it guarantee that consumption of a food product prepared, sold, bought on its campus or brought onto its campus by a student or visitor will not result in some form of allergic reaction, or that students, guests or visitors will not come into contact with any allergens while at Moraine Park Technical College.

Recognizing those risks, the Undersigned voluntarily chooses to participate in and expressly assumes all risk of the activity taking place on the Moraine Park Technical College campus.

In consideration of allowing the Undersigned to participate in the activity at the Moraine park Technical College campus, the Undersigned further hereby agrees NOT TO SUE, TO HOLD HARMLESS AND TO RELEASE MORAINE PARK TECHNICAL COLLEGE AND ITS INSURANCE CARRIERS, AGENTS, EMPLOYEES, GUIDES, REPRESENTATIVES, OWNERS, AND LESSORS FROM ANY AND ALL LIABILITY AND CLAIMS FOR INJURY OR DEATH TO PERSONS OR DAMAGE TO PROPERTY ARISING FROM THE UNDERSIGNED’S PARTICIPATION IN THE ACTIVITY TAKING PLACE ON THE MORAINE PARK TECHNICAL COLLEGE CAMPUS, INCLUDING THOSE INJURIES, DEATH AND/OR DAMAGES CAUSED BY MORAINE PARK TECHNICAL COLLEGE OR ANY OTHER RELEASED PARTY’S ALLEGED OR ACTUAL NEGLIGENCE OR BREACH OF ANY EXPRESS OR IMPLIED WARRANTY.

Parent/Guardian Name*

First Last

Student Name*

First Last

Date*

Main Contact Phone Number*

Work/Alternative Phone Number

Insurance Carrier

Member ID #

Consent*

I acknowledge the guidelines of this liability form.

By signing this contract, I give my permission to Moraine Park Technical College to proceed with emergency medical care and to sign necessary medical release forms. This permission is given with the understanding that the attending physician deems emergency medical attention is necessary. Moraine Park will make every effort to reach the guardian prior to assuming the responsibility for signing a release for emergency medical treatment. I further acknowledge that primary health insurance for the student will be under my coverage and is my responsibility. This authorization will be used only in the event that the guardian cannot be reached.

Signature*

First Middle Last

Tech Knowledge College Liability and Publicity Release Form

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