The undersigned whose name printed below, hereby explicitly releases the Mid-Jersey Chinese School, its board of directors, principal, teachers and administrators from any liabilities including but not limited to personal injury, loss of properties and any damages associated with the student(s) whose name(s) listed below, attending the Mid-Jersey Chinese School and/or participating any of the school activities.

The undersigned hereby consents to be held personally responsible for any damages resulting from the student’s conduct while attending the Mid-Jersey Chinese School and/or participating any of the school activities.

It is understood that if student is enrolled in any physical activities like but not limited to yo-yo, kung-fu, or dance, various injuries may occur. I also understand that it is my responsibility to make sure my child is physically capable of participating in these programs and a physical exam by a doctor is recommended.

I verify the address below is the permanent residence of the named students and that all the information stated below is, to the best of my knowledge, true and correct. Any intentional falsifying of information will result in automatic expulsion of my child/ward from the school/program. I agree to abide by all rules, regulations, and policies as set forth by the Mid-Jersey Chinese School and teachers/coaches. East Brunswick Township and the Board Of Education is not a sponsor of any activity and are held harmless.