Bus Authorization Authorization I give permission for my child to travel by bus back and forth between his/her bus stop and My French Programs camp located at Ste Jane de Chantal School 9525 Old Georgetown Rd in Bethesda, MD 20814. Waiver Hold harmless I hereby agree to hold harmless My French Programs, its subsidiaries and parent company as well as its directors, officers, employees, contractors and agents, from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, related to the bus transportation of my child by My French Programs, including but not limited to all claims for compensation, bodily injuries, and property damages whether arising out of alleged negligence. Emergency Medical Treatment Emergency Medical authorization I authorize emergency medical treatment in the event of an accident and I understand that every reasonable effort to notify us will be taken upon learning of an accident and/or prior to rendering emergency treatment. Camper Name of camper * Please list first and last name of camper. Emergency Contact Emergency Contact Name * Please list first and last name of emergency contact. Emergency Phone * Persons authorized to pick-up camper List of persons authorized to pick up camper * Please list first and last name of persons authorized to pick-up camper at bus stop. Signature Please type your name here as signature of the form above: Form should be completed by parent or legal guardian. 1 Start 2 Complete
