The Depot Youth Center


MISTLETOE MAGIC PRE- PARTY PERMISSION SLIP/WAIVER
Student First Name *
Student Last Name *
Address 1 *
Address 2
City *
State/Province
Zip *
Birth Date *	// (mm/dd/yyyy)
School *
Current Grade *
PARENT/GUARDIAN *
Parent/Guardian Cell Phone *
Parent/Guardian email *
I give my child permission to attend the Mistletoe Magic Pre- Party at the Depot Youth Center (“Depot”) on December 6, 2019 and to be driven to the Mistletoe Magic event to be held at Darien Town Hall by Depot volunteers.
I, also do hereby release, waive, discharge, and covenant not to sue The Depot, its directors, officers, employees, volunteers, independent contractors, sponsors, and agents from liability from any and all claims arising from negligence of The Depot or any of the aforementioned parties. This agreement applies to 1) personal injury from accidents or illnesses arising from using the property, facilities, and services of The Depot including, but not limited to, organized events and individual use of facilities, premises, or equipment; and to 2) any and all claims resulting from the damage to, loss of, or theft of any property. The laws of the State of Connecticut govern this agreement.
Parent Signature *

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