School Opening Ceremony Form

SCHOOL OPENING CEREMONY AUTHORIZATION AND INFORMATION FORM

School and Event Identification

School Name:

Event: School Opening Ceremony — Date: Time:

Location:

Student Information

Date of Birth:    Grade/Program:

Primary Phone:    Email:

Parent / Guardian Information

Relationship to Student:

Day Phone:    Alternate Phone:

Attendance, Transportation and Logistics

Student will attend the School Opening Ceremony: Yes No

Transportation arrangements (select all that apply):

School bus    Parent/guardian drop-off and pick-up    Walk / Bike    Other:

Emergency Contact and Medical Information

Relationship:    Phone:

Medication to be administered during event (name, dose, schedule):

I authorize school personnel to administer or to arrange emergency treatment if necessary, including transportation to a medical facility when I cannot be reached. I understand that the school will attempt to contact me prior to non-emergency treatment whenever possible.

Acknowledgement: I acknowledge and agree to the emergency treatment authorization and related statements above.

Media Release and Use of Likeness

The school routinely photographs and records events for educational and promotional purposes. By checking "Yes" below, I grant the school and its agents a nonexclusive, royalty-free right to use, reproduce, publish and display my child's name, voice, image and likeness in school publications, social media, printed materials and multimedia without compensation. I understand the school will not be obligated to use any photograph or recording.

Yes, I grant permission    No, I do not grant permission

Conduct, Safety and Liability

Students are expected to comply with the school's code of conduct and all event-specific safety instructions. Failure to observe rules may result in removal from the event and parent/guardian notification. While the school will exercise reasonable care to protect participants, the undersigned agrees that the school, its employees and agents shall not be liable for ordinary negligence in the absence of willful misconduct.

Acknowledgement of conduct policy: I have read and accept the requirements and potential disciplinary measures described above.

Fees, Tickets and Donations

Admission or participation fee (if any):

Payment method: Cash Check Card

Volunteering and Background Screening

I am willing to volunteer at the event: Yes No

If volunteering, I understand that I may be required to complete background screening and to comply with volunteer policies.

Additional Information

Legal Certifications and Consent

By signing below I certify that I am the parent or legal guardian of the student named in this form, or the student if of legal age. I have the authority to grant the permissions requested. I confirm that the information provided on this form is true and accurate to the best of my knowledge. I release and hold harmless the school, its employees and agents from claims arising out of ordinary negligence in connection with routine event activities, except as prohibited by law. I authorize emergency medical treatment as described above and agree to be responsible for expenses incurred for such treatment.

I understand that completion of this form constitutes express consent to the selected permissions and acknowledgements and is effective for the date of the listed event unless otherwise revoked in writing prior to the event.

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