Dear Parents/Guardians,
April 19, 2010
Thank you for a wonderful rugby season! The Saint David varsity girls rugby team has learned how to work together in
order to perform on the field as a team. Rugby is an unbelievably complicated sport, requiring both specialized knowledge
and well-developed fitness capabilities. These young ladies have truly risen to the occasion and they play with heart,
commitment and skill.
We have been invited to play an exhibition match at St Mary’s CSS on Thursday, April 21 at 3:30 pm. We will be travelling
by bus, however since this is outside of regular season play, an additional permission form is required. Players are required
to ride the bus back to school after the game, unless they are travelling with their own parent or a volunteer driver (with all of
the necessary forms filled out in advance – volunteer drivers forms are part of the initial document “Forms” on ClassNet).
See you on the pitch!
PARENT CONSENT/PERMISSION FORM FOR EDUCATIONAL TRIPS
(students under 18, detailed form for activities with obvious inherent risk)
THIS FORM MUST BE READ AND SIGNED BY EVERY STUDENT WHO WISHES TO PARTICIPATE AND BY A
PARENT OR GUARDIAN OF A PARTICIPATING STUDENT.
St. David Catholic Secondary School Athletics Department, of the Waterloo Catholic District School Board is
arranging Girls Varsity Rugby Team, with bus travel to an exhibition game at St Mary’s CSS on Thursday, April
21, 2010.
Educational activity programs, such as RUGBY, which is being offered, involved certain elements of risk.
Accidents may occur while participating in these activities. These accidents may cause injury.
Examples of the type of accident that could occur are:
1. Broken bones, sprains
2. Concussion
3. Bruises, scrapes
These accidents result from the nature of the activity and can occur without any fault on either part of the
student, or the School Board or its employees or agents, or the facility where the activity is taking place. By
choosing to participate in the activity, you are assuming the risk of an accident occurring.
The chance of an accident occurring can be reduced by carefully following instructions at all times while
engaged in the activity.
If you choose to participate in, you must understand that you will bear the responsibility for any accident that
might occur.
The Waterloo Catholic District School Board does not provide any accidental death, disability, dismemberment,
dental, or medical expenses insurance on behalf of the students participating in this activity.
The Waterloo Catholic District School Board strongly advises that all students participate in the STUDENT
ACCIDENT INSURANCE PLAN offered by the Reliable Life Insurance Company and which covers participants
for all accidents, 24-hours per day, every day during the full policy term.
ACKNOWLEDGEMENT
WE HAVE READ THE ABOVE. WE UNDERSTAND THAT IN PARTICIPATING IN THE ACTIVITY, WE ARE
ASSUMING THE RISKS ASSOCIATED WITH DOING SO.
Signature of Student:____________________________________ Date: ____________________
Signature of Parent/Guardian: ____________________________ Date: _____________________
PERMISSION
I give __________________________________________ permission to participate in the exhibition match at
Grand River Collegiate and to travel by bus.
Signature of Parent/Guardian: ________________________Date: __________________
NOTE TO PARENT(S): 1) STUDENTS UNDER THE AGE OF 18 ARE NOT PERMITTED TO TRANSPORT OTHER
STUDENTS.
2) PLEASE RETURN THIS FORM IN ITS ENTIRETY.