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Sati School Enrollment Form
Please enter one child per form.
Child's First and Last Name
Parent(s) First and Last Name(s)
Grade in school
Enter your child's grade placement in his/her school for the 2017-18 academic year.
Pre-K/not in school
Does your child have any medical conditions or allergies, inclusive of food allergies, that we should be aware of?
Does your child have any dietary considerations?
This helps us choose foods for the snack offering and when food might be used in class.
Consent and Waiver of Liability for Sati School Participation:
I hereby give my consent for the above named student to participate in the Sati School of the Mindful Families of Durham, Inc. I, the undersigned, hereby release and discharge the Board, the organizers, staff, and operators of the MFD and the Sati School from all liability arising out of or associated with all school related activities. For the purposes of this agreement, liability means all claims, demands, losses, causes of action, suits or judgments of any and every kind that occurs related to such activities and that results from any cause including the active or passive conduct and/or negligence of the Sati School or MFD.
I agree to the terms of the Consent and Waiver.
I DO NOT agree to the terms of the Consent and Waiver.
By typing your name below, you are providing an electronic signature agreeing to the terms of the Consent and Waiver of Liability.
Parent or Legal Guardian's Signature:
Send me a copy of my responses.
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