Skool Aid Parent Release
Email address *
Name of parent or guardian completing this form: *
Your answer
Afternoon contact number (format: 555-555-5555): *
Your answer
Program location: *
Program student(s) will attend: *
Number of students you are registering: *
Required
Grade(s) of student(s) you are registering (select all that apply): *
Required
First, last name, and grade of Student 1 (example: Johnny Doe, 3): *
Your answer
First, last name, and grade of Student 2 (if needed):
Your answer
If registering more than two students please enter the additional students below. Please include first name, last name, and grade. (example: Joni Doe, 4)
Your answer
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:
Your answer
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) *
Your answer
Please enter any additional information you would like the Skool Aid Teaching Artist to know about your child (optional).
Your answer
E-Signature: *
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.
Your answer
A copy of your responses will be emailed to the address you provided.
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