Skool Aid Parent Release
Name of parent or guardian completing this form:
Afternoon contact number (format: 555-555-5555):
Cherokee Elementary School
Creekside Early Elementary School
Freedom Elementary School
Guardian Angels School
Hyde Park Elementary School
Liberty Early Childhood School
Maddux Elementary School
Union Elementary School
VanGorden Elementary School
Wyandot Early Chldhood School
Program student(s) will attend:
Fun with Drums
Fun with Film
Passport to the World
Video Game Design
Number of students you are registering:
More than 2
Grade(s) of student(s) you are registering (select all that apply):
First, last name, and grade of Student 1 (example: Johnny Doe, 3):
First, last name, and grade of Student 2 (if needed):
If registering more than two students please enter the additional students below. Please include first name, last name, and grade. (example: Joni Doe, 4)
Media Release - please read the following statement and agree or disagree:
I agree that Skool Aid may use any image of my child, photograph, testimonial, or likeness, in its promotional materials and publicity efforts without additional compensation. I understand that these photographs, images, video, or audio, may be retouched or enhanced and may further be used in publications, print ads, electronic media, (eg., video, CD-ROM, Internet/website), or other media now know or hereafter created at any time. I further understand that by participating in the photography or filming, I release Skool Aid and its representatives, licenses, employees, photographers, and their designs from any and all liability for any violation of any privacy or proprietary rights.
Please list any allergies or dietary restrictions:
I authorize the following person(s) to pick-up my child at the completion of each session. Please include name, relationship, and contact number. (example: John Doe, Father, 555-555-5555)
Please enter any additional information you would like the Skool Aid Teaching Artist to know about your child (optional).
By entering my name below, I confirm that Skool Aid may release my child to the person(s) listed above and all above information provided is correct.
A copy of your responses will be emailed to the address you provided.
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