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}{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid4793062\charrsid4793062 Distrito Escolar de }{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid4793062 Lancaster \par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1655777 {\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid4793062 Privilegio}{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid4793062\charrsid4793062 de Seguro de Accidente}{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid4793062 }{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid4793062\charrsid4793062 \endash }{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \b\fs28\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid4793062 }{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 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\ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15628899 . }{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid15628899\charrsid15628899 El estudiante no tiene tal seguro en vigor}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15628899 ;}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid15628899\charrsid15628899 sin embargo, el estudiante}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15628899 (}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid15628899\charrsid15628899 y representante legal}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid15628899 si se aplica}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15628899 ) }{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid14693174 ha pedido que el estudiante sin embargo sea permitido participar en el programa}{ \rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15628899 . }{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid14693174\charrsid9182386 Aunque precauciones de seguridad son tratadas en la escuela, lo natural del programa}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid9182386\charrsid9182386 conducido por la escuela permite la posibilidad de un accidente o una herida}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid9182386 m\'e1s grande que en un t\'edpico sal\'f3n de clases}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9182386 . }{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid9182386\charrsid9182386 Por esta raz\'f3 n, la escuela requiere la firma de este documento como una condici}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid9182386 \'f3n para participar en el programa}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9182386 . \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9182386 \par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\fs20\ul\lang20490\langfe1033\langnp20490\insrsid9182386\charrsid15683010 TESTIMONIO}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\fs20\ul\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15683010 : \par \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15683010\charrsid15683010 Con la intenci\'f3 n de ser legalmente seguro}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15683010 , }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15683010 y}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15683010\charrsid15683010 o aqu\'ed presente}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid15683010 : \par \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar \jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 Tengo conocimiento que hay un riesgo inherente de accidente para el estudiante en el programa operado por la escuela}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9111528 ,}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 y que la escuela ha recomendado la compra de una }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid810792\charrsid9111528 p\'f3liza}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 de salud o seguro que proteja al estudiante}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9111528 . \par }\pard \ltrpar\ql \li360\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin360\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9111528 \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar \jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 Tengo conocimiento que he rechazado la compra de una }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid810792\charrsid9111528 p\'f3liza}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 de seguro y sin embargo deseo que el estudiante participe en el programa}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9111528 . \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9111528 \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 \hich\af0\dbch\af0\loch\f0 3.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar \jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 Estoy de acuer}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid810792 d}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 o que yo, como estudiante o representante legal del estudiante}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid9111528 , }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528\charrsid9111528 estoy asumiendo los riesgos de cualquier accidente el cual puede resultar de la participaci}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528 \'f3n del estudiante en el programa}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid9111528 , }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid9111528 o}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360 por el transporte hacia o desde los sitios usados en el programa}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid9111528 , }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360 sin importar las causas de tal accidente}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid9111528 .}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid8473666\charrsid9111528 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1655777 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid9111528 \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360\charrsid15085802 \hich\af0\dbch\af0\loch\f0 4.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar \jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360\charrsid15085802 Libero la escuela, y tambi\'e9n al }{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\fs20\lang20490\langfe1033\langnp20490\insrsid2897360\charrsid15085802 Distrito Escolar de }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 Lancaster, }{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360\charrsid15085802 y sus oficiales}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 , }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360\charrsid15085802 directores}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 , }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid2897360\charrsid15085802 empleados y agentes}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802\charrsid15085802 de cualquier responsabilidad por da\'f1 os, heridas, o gastos el cual puede resultar de la participaci}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802 \'f3n del estudiante en este programa}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 . }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802\charrsid15085802 Yo entiendo que al firmar esta liberaci\'f3 n yo estoy liberando cualquier y todos los reclamo}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802 s}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 , }{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802 incluyendo reclamos por gastos m\'e9dicos o deducirlo de la }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid810792 p\'f3liza}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802 de seguro familiar o individual}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 . \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1655777 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid15085802 \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802\charrsid5647803 \hich\af0\dbch\af0\loch\f0 5.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar \jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid8473666 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid15085802\charrsid5647803 REPRESENTO A LA ESCUELA QUE HE LEIDO}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid5647803\charrsid5647803 ESTE FORMULARIO, LO ENTIENDO}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 , }{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid5647803\charrsid5647803 LO FIRMO VOLUNTARIAMENTE, Y CON LA INTENCI}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid5647803 \'d3 N QUE ESTA LIBERACI\'d3N SEA LEGALMENTE SEGURO PARA MI, MIS HEREDEROS Y ASIGNADOS.}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1655777 {\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 \par }\pard \ltrpar\ql \li360\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin360\itap0\pararsid1655777 {\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid5647803 Fecha}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid1655777 : ________________________________\tab ________________________________ \par \tab \tab \tab \tab \tab \tab \tab (}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid5647803 Firma del Estudiante}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid1655777 ) \par \par _____________________________________\tab ________________________________ \par }{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 (}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid5647803\charrsid5647803 Escriba Nombre del Estudiante}{ \rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 )\tab \tab \tab (}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid5647803 Firma Padres}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 /}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid5647803 Representante Legal}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\lang20490\langfe1033\langnp20490\insrsid1655777\charrsid5647803 ) \par \par \tab \tab \tab \tab \tab \tab \tab }{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid1655777 ________________________________ \par \tab \tab \tab \tab \tab \tab \tab (}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid5647803 Firma Padre}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid1655777 /}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid5647803 Representante Legal}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid1655777 )}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \fs22\insrsid1655777\charrsid1655777 \par }}