HOLD HARMLESS AND WAIVER OF LIABILITY AGREEMENT

							HOLD HARMLESS AND WAIVER OF LIABILITY AGREEMENT

As the parent or guardian of ___________________________________, a student at the
Math and Science Academy (MSA), I hereby grant permission for my child to leave
MSA school grounds for the lunch period. I understand that MSA will not provide any
transportation or supervision for such activities and I agree to assume full responsibility
for my child during such activities off the grounds of MSA.

In consideration for MSA allowing my child to leave MSA grounds for the lunch period,
I hereby forever release MSA, Its employees, directors, or agents from any and all
liability for any damages or injuries suffered by my child or his/her property while
engaging in these activities, and agree to hold them harmless there from.


______________________________________                    ___________________
Parent or Legal Guardian’s Signature                       Date



In consideration of the above statements, I (circle one) do do not give permission for
my child, listed above, to transport other MSA students.


______________________________________                    ___________________
Parent or Legal Guardian’s Signature                       Date


I revoke the right of _____________________________ to leave the MSA school
grounds during lunch.       (Student’s Name)




______________________________________                    ___________________
Parent or Legal Guardian’s Signature                       Date