I am the parent/legal guardian of the child listed above who is/are under 18 years of age and desire that the ‘student(s)’ participate in SLA’s DAYPASS Program.  I acknowledge that I must advise the Program Director in writing if the student is not physically fit to participate fully in the activities.  I also acknowledge that there may be risks in participating in these activities and agree that, having taken such precautions as in its discretion are deemed advisable, SLA Program Directors will not be held responsible for any injury, sickness or accident to the Student or for any loss or damage to personal property resulting from the student participating in the activities.  I authorize the directors to secure medical care for the student(s).  If for any reason the student(s) requires medical attention beyond any first aid furnished by or on behalf of the Program Directors, I agree to be responsible for any expenses incurred.  I agree to indemnify SLA, it’s officers, directors, agents and employees and save them harmless from and with respect to all suits, actions and prosecutions by reason do any activity carried out by the e student(s, whether on or off the school property.  I consent to the use do the likeness (including still photographs and videos) of the student(s) in connection with the school and related institutional promotional purposes throughout the world and without any compensation.  

I expressly release St. Lawrence Academy, its officers, directors, agents, employees, licensees and assigns from and against any and all claims for invasion of privacy, defamation, and infringement of copyright or any other cause of action that may arise out of such use. 

I hereby irrevocably release St. Lawrence Academy from any and all claims for libel and invasion of privacy in connection with the foregoing. 

I, the undersigned, have read the above and agree to its terms: