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Trip to the African-American Museum of History & Culture

the parent/legal guardian of ("Participant"), hereby consent to Participant's travel to/from and participation in the above checked field trips (each a "Field Trip").

I understand that travel may be by foot, bus, van, car, and/o r other vehicle. I acknowledge that participation in the Field Trip can carry with it potential risks including, but not limited to, bodily injury to a Participant, and I agree to assume all of the risks and hazards associated with each Participant's travel to/from and participation in the Field Trip. I hereby agree to release, discharge, indemnify, and hold hannless the District of Columbia and DPR, and their respective agents, officers, employees, contractors, and volunteers, from any and all liabilities, claims, penalties, suits, demands, judgments, costs, interest, and expenses (including attorneys' fees and cost ). directly or indirectly arising from or connected in any way to Participant's travel to/from and participation in the Field Trip, including, without limitation, in connection with any incident involving injury to, death of, or loss of property by, a Participant.

In the event of an injury to a Participant requiring medical attention, I hereby grant permission to the supervising staff (including volunteers) to attend to the injured Participant. In the event of an injury to a Participant that warrants further medical attention, I understand that unless there is an emergency, DPR will attempt to contact the below identified emergency contact. If efforts to reach the emergency contact are unsuccessful, or in the event of an emergency, I grant permission to the District of Columbia and DPR to seek further medical treatment for Participant. I agree to accept full responsibility for and to pay the cost of medical care, transportation, and any other incidental expenses arising from any such event.

In the event that a Participant is unable to participate in the Field Trip for reasons of health, accident, failure to comply with directions of the staff in charge, or for any other reason in DPR's reasonable determination, 1 agree to pick up the Participant from camp or the Field Trip site upon being contacted by DPR.

Unless I check the box below, I grant to the District of Columbia and DPR permission to use the Participant's words, work products, and/or likeness (including photographs), to describe, evaluate, promote, and publicize DPR programs.