Trường Việt Ngữ Thăng Long
Thang Long Vietnamese Language School
http://tvnthanglong.org
Giấy Cam Kết - Khoá Mùa Thu 2009 & Xuân 2010
(Waiver Form for Thang Long Vietnamese Language School - Fall 2009 & Spring 2010)
Student’s name /Tên Học Sinh: _______________________________________________________________
Date of Birth/Ngày Sinh:_____________________________________________________________________
Parents’ name/Tên Cha Mẹ Học Sinh: _________________________________________________________
Home Phone/Số Điện Thoại Nhà: _______________________ Cell phone/Số cầm tay: ________________
E-mail/Điện Thư: __________________________________________________________________________
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Địa Điểm & Giờ Giấc Sinh Hoạt (Place & Hours of Operation)
First Vietnamese-American & Arlington Forest United Methodist Church
4701 Arlington Blvd.
Arlington, VA 22203
9:30 AM - 12:00 Noon mỗi Thứ Bảy (Every Saturday)
I, the undersigned, permit my child to participate in all school activities organized by the Thang Long Vietnamese Language School. I understand that there are unforeseeable risks. Neither Thang Long Vietnamese Language School, First Vietnamese-American United Methodist Church, nor the Arlington Forest United Methodist Church will provide any insurance coverage for my child and his parents/guardians while being at/around the church property. I am completely responsible for the safety of my child and myself.
I hereby release and agree to indemnify and hold harmless Thang Long Vietnamese Language School, the First Vietnamese-American United Methodist Church, the Arlington Forest United Methodist Church - their employees, officers, volunteers and affiliates, all of whom hereinafter will be referred to as releasees - ad infinitum from any and all damages, claims, actions, liability and expenses (including costs of judgments, settlements, court costs, and attorney's fees), regardless of the outcome of such claims or actions, arising out of my and my child’s participation in the foresaid activities, notwithstanding liability may result from the negligence of the releasees. This Release shall be binding upon not just myself but also any person suing on my behalf and/or my child’s behalf.
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Parent’s/Legal Guardian’s Signature Date Signed
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