I, the undersigned, give my permission for my child/ward named above to participate inactivities sponsored by the DeLand Police Athletic League (DPAL) .

MEDICAL RELEASE AND CONSENT FOR TREATMENT

In the event of injury or other conditions arising from activities while participating as amember of DeLand Police Athletic League (DPAL), which necessitates emergency medical treatment for the minornamed herein, I do hereby give consent and permission in my absence for any treatment,which may be needed, as called for by the circumstances.

WAIVER OF LIABILITY

I do hereby intend to be legally bound and, for myself, executors and administrators dowaive, release and forever discharge any and all rights and claims for damages against DeLand Police Athletic League (DPAL) , the City of DeLand, and the employees, agents, officers and volunteers of DeLand Police Athletic League (DPAL) and the City of DeLand, including any claim for loss, damages or injury to theperson or property of the minor named herein, arising out of his/her performance orfailure of performance while participating as a member in a sponsored activity of DeLand Police Athletic League (DPAL) .

NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TOLET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE WVP AL OR THE CITYOF DELAND USES REASONABLE CARE IN PROVIDING THIS ACTIVITY,THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLEDBY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'SRIGHT AND YOUR RIGHT TO RECOVER FROM THE WVP AL AND THE CITYOF DELAND IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOUHA VE THE RIGHT TO REFUSE .TO SIGN THIS FORM, AND THE DeLand Police Athletic League (DPAL) AND THE CITY OF DELAND HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM

PHOTO/MEDIA RELEASE:

I acknowledge, understand, consent and permit my child as a participant in the DeLand Police Athletic League (DPAL) programs and events that involve interviewing, photographs, videotaping, publicity activities while participating in DeLand Police Athletic League (DPAL) programs and events.

SCHOOL RECORDS RELEASE STATEMENT:

I give my consent for my son's/ daughter's/ ward's school records to be accessed by the DeLand Police Athletic League (DPAL) through the Volusia County School system. This is to enable the DeLand Police Athletic League (DPAL) staffto gather data for program effectiveness, financial and academic eligibility.

TRIP PERMISSION FORM:

I give permission for my child/ward to participate in any DeLand Police Athletic League (DPAL) program trip(s)whereby his/her participation in a designated away competition / event is scheduled. Iunderstand that I will receive advanced notice of these field trips and the specific detailsas they relate to that event.

*Only a legal guardian and/or parent may register and sign this form. By signing below, Iacknowledge that I understand and agree to all of the above. In addition, I certify that I am the legalguardian and/or parent of this applicant.*