DATE OF EVENT:       Saturday,                                                         

DESCRIPTION OF EVENT: Removing trash from sides of Highway 280 northbound between the Meridian Avenue and Saratoga Avenue; The Alameda on-ramp and off-ramp to Highway 17 northbound; the Meridian/Southwest Expressway interchange.

Safety vests, safety goggles, gloves, and hard hats will be provided. Workshifts will be no more than 3 hours

I am aware that my son/daughter                                                                              will be participating in the event described above. I have spoken to my son/daughter about the reasons for his/her participation and the possible hazards involved. I understand there will be adult supervision at a ratio of one adult for every five minors. I expect my son/daughter to behave responsibly and follow all instructions from the adult supervisors.

I accept that my son/daughter will be at risk and agree to hold the organizers of this event harmless in the event of any damage, injury, or accident that is not within their ability to control.

REGARDLESS OF THE WEATHER my son/daughter will wear the proper clothing for this event:

  X    long pants         ....... no matter how hot it is!
  X    long sleeved shirt       ....... no matter how hot it is!
  X    socks          ....... no matter how hot it is!
  X    boots or other sturdy closed-toed, lace up shoes
          (no flip-flops or sandals!)

My son/daughter and I have read the above.



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