Creation Explorations, Inc.

Physical Science Lab Registration and Liability Waiver

Test booklets are optional. Physical Science Lab Cost: $120 per student

Students name (please print)                                            Grade in School Students age

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Parent or legal guardian information:

Name ________________________________________________e-mail_______________________________________

Address ________________________________________________________

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Telephone: Home_______________________ Work:__________________________ Cell:____________________________

Other Parent or legal guardian who may bring or pick up student:_______________________________________________

Liability Wavier
Creation Explorations, Inc. is dedicated to offering athletic programs, science programs, fossil floats, and nature trips conducted in the safest manner possible, and hold this safety in the highest regard. We pride ourselves with our past safety record, and will continue to offer activities always keeping safety in the forefront. Students and parents must recognize the inherent risks involved with these activities, including injury and death. By signing below, the parent or legal guardian acknowledges that Creation Explorations, Inc. does not carry any medical accident insurance for injuries sustained while participating in activities. We recommend parents and legal guardians review their own medical insurance policies.

Recognizing these risks, the parent or legal guardian signing below, assumes these risks, and forever releases Creation Explorations, Inc., its owners, coaches, officers, agents, sponsors, participants, employees, and helpers as well as the property owners of the premises where the activities take place, from any and all liability of injury, death, or property damage sustained by the students, parents, or guardians while participating in or watching activities. Furthermore, in the event of an injury of a student, we will make an attempt to locate the parent or guardian to determine what medical treatment, if any, is necessary. If Creation Explorations Inc., or its owners, coaches, officers, employees, or helpers determine medical treatment is necessary before the parent or guardian is located, they will begin treatment and or call for professional medical assistance.

By signing below, the parent or legal guardian releases Creation Explorations, Inc., its coaches, owners, officers, agents, employees, or helpers, from any and all liability for any treatment given to students or participants, and assumes all costs of any treatment, if professional medical treatment is necessary, including but not limited to ambulance transportation charges.

Name or parent or legal guardian (please print)_____________________________________________________

Signature of parent or legal guardian_________________________________________date_________________

Witness______________________________________________________________date_________________

At Creation Explorations, Inc., we enjoy working with children and look forward to getting to know them as well as parents and guardians, however it is imperative that those children being dropped off (ages 12 years and up) be picked up promptly at the end of the session. By initialing below the signee understands there is a $15.00 charge to any parent or guardian who does not pick up their student(s) within 10 minutes of the ending time of the session.

Initials___________