2019 Variety Show Parent Permission and Student Waiver
A SEPARATE FORM MUST BE COMPLETED FOR EVERY VARIETY SHOW PARTICIPANT. PARTICIPANTS WITHOUT A PERMISSION SLIP/WAIVER ON FILE WILL NOT BE ALLOWED TO PERFORM.

My (our) child has permission to participate in the Hillcrest Variety Show on Saturday, April 6, 2019, at the Tivoli Theatre. I (we), as parent(s) or guardian(s) of the minor do hereby, for my (our) son/daughter, heirs, executors and administrators, remise, release and forever discharge the Tivoli Theatre, the Hillcrest PTA, the Illinois PTA, all Hillcrest PTA officers and agents of each of the foregoing, acting officially or otherwise, from any and all claims, demands, actions or causes of action on account of referred. I (we) hereby certify that the minor is my (our) son/daughter or legal ward. I (we) hereby certify that to the best of my (our) knowledge and belief, said minor is in good health. In case of illness or accident, permission is granted for emergency treatment to be administered. It is further understood that the undersigned will assume full responsibility for any such action, including payment of costs.

Terms and Conditions
By clicking the "I agree" button below and submitting this form, I (we) give permission for my (our) child/legal ward to participate in the 2019 Hillcrest Variety Show per the terms above. Alternatively, clicking on "I don't agree" will deny permission for my (our) child/legal ward to participate in the show.
Acceptance *
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Below, please list any medical or physical conditions, allergies, reactions, etc. that should be made known to a treating physician if needed.
Medical/Physical Conditions. If none, write "none" *
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Contact / Act Information
Parent/Legal Guardian Name *
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Parent/Legal Guardian Phone Number *
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Parent/Legal Guardian Email Address *
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Participating Student's Name *
Your answer
Student's Grade *
Act Coordinator *
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