BE ADVISED. It is the Parents/Guardians responsibility to pick up student medication by student dismissal the last day of the school. Medications left unclaimed will be disposed of according to the Colorado Department of Human Services (CDHS) “Guidelines for Medication Administration (2008).” Signature of Parent or Guardian Month/Day/Year PRIMARY CARE PROVIDER (PCP) SIGNED ORDER FOR MEDICATION This form must be completed for any medication a student will need to take during school hours. Please be aware that any medications, including samples, must have a medication label to be administered at school. Student’s Name: Grade: Date of Birth: / / Medication/Treatment Name (one per form) Dosage: Route: Frequency: Times given at School: / / Starting date: Ending date: or until end of school year 2018-2019 / / Purpose of Medication: Allergies: NKDA Other: _ Possible Side Effects: _ (Print) Name of PCP or Dentist Prescribing Medication Phone: Fax: Signature of PCP w/Prescriptive Authority Medication Discontinued: Time: Date: / / and Date: Clinic Name: / / PCP Signature: _ / Date: / / (Print) Name of School Nurse Signature of School Nurse School Nurse Signature indicates that the medication and medication orders have been reviewed by School RN
BE ADVISED. It is the Parents/Guardians responsibility to pick up student medication by student dismissal the last day of the school. Medications left unclaimed will be disposed of according to the Colorado Department of Human Services (CDHS) “Guidelines for Medication Administration (2008).” Signature of Parent or Guardian Month/Day/Year PRIMARY CARE PROVIDER (PCP) SIGNED ORDER FOR MEDICATION This form must be completed for any medication a student will need to take during school hours. Please be aware that any medications, including samples, must have a medication label to be administered at school. Student’s Name: Grade: Date of Birth: / / Medication/Treatment Name (one per form) Dosage: Route: Frequency: Times given at School: Starting date: / / Ending date: / / or until end of school year 2019-2020 Purpose of Medication: Allergies: NKDA Other: _ Possible Side Effects: _ Phone: Fax:
BE ADVISED. You must sign this Agreement to purchase the Pass at a discounted price from the day ticket price or to participate in certain Activities at a Resort. The Pass does not guarantee access to a Resort for a minimum or a maximum number of days in each season or that a Resort will be open for a minimum or a maximum number of days each season. Use of the Pass to access a Resort is subject to, among other things, the Resort being open and having the capability and/or capacity to grant access. Each Resort reserves the right to close or limit access to the Resort for weather, safety, or any other reason at its sole discretion with or without notice during each season. I understand, accept and agree that use of the Pass is subject to the length and occurrence of each season, which may be affected by weather, weather-related events, travel advisories, public health or government order, or any other event or occurrence that limits or prohibits a Resort from its full or partial operations. I understand, accept and agree that the Pass is for the sole use of the individual to whom it is issued, that such individual’s likeness, name, and/or other specific information will be associated with the Pass account and visible to Resort staff, and that the Pass is NOT TRANSFERABLE, CANNOT BE USED BY ANYONE OTHER THAN THE INDIVIDUAL TO WHOM IT IS ISSUED and CANNOT BE RESOLD. I also understand, accept and agree that my Pass may be confiscated, revoked or suspended, if, in the sole judgment and discretion of a Resort or Alterra Mountain Company, I act in any manner that endangers or may endanger the safety of me or another person; I violate the law or Resort policy; or I provide ski/snowboard lessons, guided tours, or other services at the Resort for compensation without the Resort’s prior express authorization; I use the Pass in a fraudulent manner; or I engage in misconduct, abuse Resort staff or other participants, or create a disturbance or nuisance; or I revoke this Agreement. I further understand, accept and agree that such acts may also be prosecuted as a criminal offense, as applicable. I acknowledge the affirmative duty to immediately notify the issuer if my Pass is lost or stolen. AGREEMENT EFFECTIVE UNTIL REVOKED I UNDERSTAND, ACCEPT AND AGREE THAT THIS AGREEMENT WILL REMAIN IN EFFECT UNTIL I PROVIDE WRITTEN REVOCATION TO EACH APPLICABLE RESORT, IF THE REVOCATION IS INTENDED TO APPLY TO ALL RESORTS, AND THE REVOCATION IS COUNTERSIGNED BY AN AUTHORIZED SIGNATORY OF EACH AP...
BE ADVISED. The City reserves the right to determine responsivity and responsibility at the time of award, to reject any and all Proposals, to re-advertise the proposed improvements, and to waive technicalities.
BE ADVISED. Under South Dakota law, no fishing tournament sponsor or fishing professional is liable for an injury to, or the death of, a participant resulting from the inherent risks of fishing, pursuant to 20-9-47 to 20-9-51 of South Dakota Codified Laws. Participation Agreement: I understand that this is a professional sporting event governed by the rules that have been established by tournament organizers. I acknowledge that I have received a copy of these rules and have read them and understand them. In addition to the terms of entry and competition, these rules relate to the safety of all participants as well as the fair sporting conduct of this event. Tournament Director shall act as the referee in all disputes and his/her decision based on the rules shall be final. I understand that there are no refunds for entry fees. -------------------------------------------Date First Entrant ------------------------------------------Date Second Entrant ------------------------------------------Date Third Entrant Date
