Parental Permission Form

Students 14, 15, 16, and 17 years of age must of obtain parent signature and bring this form to House Captain at assigned house site on April 30, 2022. Younger students are not permitted to work because of insurance constraints.

In consideration of the opportunity afforded my child to assist on a voluntary basis in Christmas in April* Prince George’s Country, Inc., a project in which the home of disabled and/or elderly persons will be repaired and/or improved by volunteers, and in light of the stated goals and purposes of community service to be provided by Christmas in April in organizing this project, I give my permission for my child to participate in the Christmas in April Program, and, I, on behalf of my child and myself, waive any and all right or cause of action arising directly or indirectly from my child’s participation in said project from which any liability may or could accrue against Christmas in April* Prince George’s County, Inc., or its membership of officers and directors, collectively or individually. Without limiting the generality of the foregoing, I, on behalf of my child, agree that this waiver shall include any rights or causes of action resulting from personal injury to my child or damage to my child’s property sustained in connection with my child’s activities with the Christmas in April program.

Parent Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Phone #

(###)

###

####

My child is covered by health insurance

Yes

No

PARENTAL PERMISSION FORM

Christmas in April, Prince George’s County

EIN: 52-1623793