Students_test_forms

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WAIVER, RELEASE AND INDEMNITY AGREEMENT
In consideration of my child being enrolled and permitted to attend school, make trips and participate in school activites and athletics, and to the full extent allowed by law, I HEREBY AGREE TO WAIVE AND RELEASE THE SHELTON SCHOOL , its
Trustees, Administrators, Head of School, Faculty, school nurses, agents, employees, volunteers and invitees, together with all persons,
including parents of students at the Shelton School assisting with school activities, functions, athletics or field trips (collectively referred to
as “RELEASEES”) FROM ANY AND ALL CLAIMS, LAWSUITS, LOSSES, DAMAGES, CAUSES OF ACTION OR OTHER LIABILITIES for any accident, injury or medical condition suffered by me or my child, which occurs at or in connectionwith the following: attending school, participating in any on and/or off campus school sponsored events, participating in any on and/or offcampus athletic activities, participating in any on and/or off campus extra curricular events/activities, participating in school sponsored fieldtrips, transportation to and from any off campus school sponsored event, field trip or athletic activity, receiving or failing to receivemedications (inclusive of prescriptive medications, Advil, Tylenol, Tums, Immodium, Sudafed PE, Claritin/Zyrtec, Delsym Cough Syrup and cough drops/throat lozenges), and participating in physical education class and/or physical education activities. THIS WAIVER AND RELEASE EXPRESSLY WAIVES AND RELEASES SHELTON SCHOOL AND ALL OTHERRELEASEES FROM ANY CLAIMS, CAUSES OF ACTIONS, LAWSUITS OR OTHER LIABILITIES ARISINGOUT OF ANY ACCIDENT, INJURY OR MEDICAL CONDITION CAUSED BY THE NEGLIGENCE OFSHELTON SCHOOL AND ANY OTHER RELEASEE.
Further, with respect to any accident, injury or medical condition suffered by me or my child which occurs at or in connection with thefollowing: attending school, participating in on and/or off campus school sponsored events, participating in on and/or off campus schoolsponsored athletic activities, participating in school sponsored field trips, participating in on and/or off campus extra curricular events andactivities, transportation to and from any school sponsored field trip, event, athletic activity or extra curricular activity, receiving or failingto receive medications (inclusive of prescriptive medications, Advil, Tylenol, Tums, Immodium, Sudafed PE, Claritin/Zyrtec, Delsym Cough Syrup and cough drops/throat lozenges), and particiating in physical education class and/or physical education activities, I ALSO HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS SHELTON SCHOOL AND ALL OTHERRELEASEES FROM ANY AND ALL CLAIMS, SUITS, LOSSES, DAMAGES, CAUSES OF ACTION OROTHER LIABILITIES, INCLUDING BUT NOT LIMITED TO ALL DAMAGES AND EXPENSES OFLITIGATION AND/OR SETTLEMENT/RELEASE, INCLUDING ANY SUCH ACCIDENT, INJURY ORMEDICAL CONDITION CAUSED BY THE NEGLIGENCE OF SHELTON SCHOOL OR ANY OTHERRELEASEE.
NOTARIZATION REQUIRED FOR SIGNATURE
STATE OF TEXASCOUNTY OF _______________________ Before me, a Notary Public, on this day personally appeared ______________________________ known tome to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he /she executed the same for the purposes and consideration therein expressed. Given under my hand and sealof the office the _____________ day of________________, 2013.
My commission expires __________________ Notary Public in and for the State of Texas.
________________________________________________ READ CAREFULLY
WAIVER, RELEASE AND INDEMNITY AGREEMENT
In consideration of my child being enrolled and permitted to attend school, make trips and participate in school activites and athletics, and to the full extent allowed by law, I HEREBY AGREE TO WAIVE AND RELEASE THE SHELTON SCHOOL , its
Trustees, Administrators, Head of School, Faculty, school nurses, agents, employees, volunteers and invitees, together with all persons,
including parents of students at the Shelton School assisting with school activities, functions, athletics or field trips (collectively referred to
as “RELEASEES”) FROM ANY AND ALL CLAIMS, LAWSUITS, LOSSES, DAMAGES, CAUSES OF ACTION OR OTHER LIABILITIES for any accident, injury or medical condition suffered by me or my child, which occurs at or in connectionwith the following: attending school, participating in any on and/or off campus school sponsored events, participating in any on and/or offcampus athletic activities, participating in any on and/or off campus extra curricular events/activities, participating in school sponsored fieldtrips, transportation to and from any off campus school sponsored event, field trip or athletic activity, receiving or failing to receivemedications (inclusive of prescriptive medications, Advil, Tylenol, Tums, Immodium, Sudafed PE, Claritin/Zyrtec, Delsym Cough Syrup and cough drops/throat lozenges), and participating in physical education class and/or physical education activities. THIS WAIVER AND RELEASE EXPRESSLY WAIVES AND RELEASES SHELTON SCHOOL AND ALL OTHERRELEASEES FROM ANY CLAIMS, CAUSES OF ACTIONS, LAWSUITS OR OTHER LIABILITIES ARISINGOUT OF ANY ACCIDENT, INJURY OR MEDICAL CONDITION CAUSED BY THE NEGLIGENCE OFSHELTON SCHOOL AND ANY OTHER RELEASEE.
Further, with respect to any accident, injury or medical condition suffered by me or my child which occurs at or in connection with thefollowing: attending school, participating in on and/or off campus school sponsored events, participating in on and/or off campus schoolsponsored athletic activities, participating in school sponsored field trips, participating in on and/or off campus extra curricular events andactivities, transportation to and from any school sponsored field trip, event, athletic activity or extra curricular activity, receiving or failingto receive medications (inclusive of prescriptive medications, Advil, Tylenol, Tums, Immodium, Sudafed PE, Claritin/Zyrtec, Delsym Cough Syrup and cough drops/throat lozenges), and particiating in physical education class and/or physical education activities, I ALSO HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS SHELTON SCHOOL AND ALL OTHERRELEASEES FROM ANY AND ALL CLAIMS, SUITS, LOSSES, DAMAGES, CAUSES OF ACTION OROTHER LIABILITIES, INCLUDING BUT NOT LIMITED TO ALL DAMAGES AND EXPENSES OFLITIGATION AND/OR SETTLEMENT/RELEASE, INCLUDING ANY SUCH ACCIDENT, INJURY ORMEDICAL CONDITION CAUSED BY THE NEGLIGENCE OF SHELTON SCHOOL OR ANY OTHERRELEASEE.
NOTARIZATION REQUIRED FOR SIGNATURE
STATE OF TEXASCOUNTY OF _______________________ Before me, a Notary Public, on this day personally appeared ______________________________ known tome to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he /she executed the same for the purposes and consideration therein expressed. Given under my hand and sealof the office the _____________ day of________________, 2013.
My commission expires __________________ Notary Public in and for the State of Texas.
________________________________________________

Source: http://www.shelton.org/uploaded/documents/parent_info/Waiver.pdf

alphabiocare.de

Parasitol Res (2012) 110:335–339DOI 10.1007/s00436-011-2495-0Observations on effects of a neem seed extract (MiteStop®)on biting lice (mallophages) and bloodsucking insectsparasitizing horsesSaleh Al-Quraishy & Fathy Abdel-Ghaffar &Khaled A. S. Al-Rasheid & Julia Mehlhorn &Heinz MehlhornReceived: 26 May 2011 / Accepted: 10 June 2011 / Published online: 22 June 2011Abstract T

Microsoft word - pharmacy general form 2-07.doc

Pharmacy Pre-authorization Request Form *Note: Please use specific forms available on the provider website when prescribing the following drugs: Proton Pump Inhibitors (i.e. Aciphex, Nexium, omeprazole, Prevacid, Protonix), Non-sedating antihistamines (i.e. Allegra, Clarinex, Zyrtec, incl. Singulair), Celebrex, Statins (i.e. Lipitor, Vytorin) and Infertility Treatments Date: ______________

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