Permission Signature Form / Waiver & Release
We, the undersigned, have read and understand and do hereby agree that the Rules and Policies of the Deerfield High School Student Handbook shall apply to Student’s (defined below) attendance at the Deerfield Parent Network Prom After Party (the “Event”). I, the undersigned Parent/Guardian, grant permission for my child (“Student”), as identified below, to attend the Event being held at the Sachs Recreation Center on May 20 - 21, 2017.

In exchange for Student being permitted to attend the Event, the undersigned Parent/Guardian and Student hereby release, waive, agree not-to-sue, indemnify, defend and hold harmless the Board of Education of District 113, Lake County, Illinois, Event sponsors, Event volunteers, Event workers, other Event attendees, Event attendees’ parents/guardians family members and any and all successors, assign, administrators, directors, trustees, teachers, employees, agents and representatives of the foregoing (collectively, the “Releasees”), from all present and future claims that may be made by Student, all members of Student’s family, estate, executor, administrator, heirs or assigns for property damage, personal injury, or wrongful death caused by the actions or omissions of the parties listed above (collectively, the “Releases”), wherever, whenever or however the same may occur as a result of Student’s attendance at, participation in and/or observation of the Event. WE UNDERSTAND AND AGREE THAT THE RELEASEES ARE NOT RESPONSIBLE FOR ANY DEATH, INJURY OR PROPERTY DAMAGE ARISING OUT OF STUDENT’S ATTENDANCE AT, PARTICIPATION IN AND/OR OBSERVATION OF THE EVENT, EVEN IF CAUSED BY A RELEASEE’S NEGLIGENCE.

Photo Policy. Photos will be taken at the Event. By signing below the undersigned hereby authorizes the use of photos on the After Party website and social media accounts without further authorization and without any compensation to the undersigned.

EVERY PERSON ATTENDING THE PROM AFTER PARTY MUST HAVE A SIGNED WAIVER ON FILE

Due Date: MONDAY May 15, 2017 at midnight

US.104708741.03

FIRST Name of Student Attending
Your answer
LAST Name of Student Attending
Your answer
Phone Number of Student Attending
Your answer
Email Address of Student Attending
Your answer
Is the above named student a Senior at Deerfield High School?
IF YOU ARE A GUEST, what is the name of the Deerfield High School student who invited you to attend The Prom After Party?
Your answer
FIRST Name of Parent or Guardian
Your answer
LAST Name of Parent or Guardian
Your answer
Home Telephone Number of Parent or Guardian
Your answer
Cell Phone Number of Parent or Guardian
Your answer
Email Address of Parent or Guardian
Your answer
Typed Signature of Parent or Guardian
Your answer
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