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.
________________________________________________
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.
________________________________________________
Herzlich Willkommen in der Gerinnungssprechstunde. Ihr behandelnder Arzt hat Sie mit Verdacht auf eine Gerinnungsstörung überwiesen. Um etwas über Ihre bisherige Krankenvorgeschichte zu erfahren, bitte ich Sie, mir einige Fragen zu beantworten. Dies ist wichtig, da Ihre Krankenvorgeschichte mir bereits entscheidende Hinweise auf die Ursache Ihrer Erkrankung geben kann, wie z.B. Hinweise dara
2008 Four-Tier Prescription Drug List Reference Guide Your UnitedHealthcare pharmacy benefit Understanding Tiers offers flexibility and choice in finding the right Prescription medications are categorized within medication for you. four tiers. Each tier is assigned a copayment, theamount you pay when you fill a prescription,which is determined by your employer or healthplan. Consul