Hello High School - Registration Form 2021
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Email *
Student's First Name *
Student's Last Name *
Grade (In September) *
Address *
City *
State *
ZIP *
Parent's Cell Phone *
Home Phone # *
Parent’s Email Address *
Student’s Email Address *
School where student is currently enrolled *
Town *
Please check the box below to confirm your enrollment in the HELLO HIGH SCHOOL Program *
Required
PERMISSION SLIP FOR PARTICIPATION
1. Parent and student acknowledge and are aware that even with proper supervision, use of protective equipment and strict observance of rules, there are risks inherent in participation in the HELLO HIGH SCHOOL Program.  Parent and student hereby release, hold harmless, indemnify and discharge Mother Seton Regional High School, its employees, agents and volunteers from all liability for damages, loss or injury to persons or property arising out of or in connection with student’s participation in the above described activity that may be filed by, on behalf of, or for the above named student.

2. For purposes of this agreement, liability means all claims, demands, losses, causes of action, suits or judgments of any and every kind that arises from student’s participation in the HELLO HIGH SCHOOL Program.

3. Parent and student further expressly agree that the foregoing release and waiver provisions are intended to be as broad and inclusive as is permitted by the law and that if any portion of it is held void, voidable, or unenforceable, the remaining portions shall remain in full force and effect.

4. The undersigned has read and voluntarily signs this release and waiver of liability and further agree that no oral representations, statements or inducements, apart from this agreement, have been made.

I hereby request that my daughter participate in the above HELLO HIGH SCHOOL Program.
Signature of Parent/Guardian *
By typing your legal name below you acknowledge to electronically sign this form.
Date *
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COST TO PARTICIPATE
Payment: $250

You will be prompted to submit payment once you submit your registration form. Please submit payment via credit card at that time. Alternatively, you can send check by mail, payable to Mother Seton Regional High School using the following address:: Mother Seton Regional High School - One Valley Rd, Clark, NJ 07066 Attn: Mrs. Patterson, Hello High School
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