Parents' Night Out Waiverdoc
Parents' Night Out Waiverdoc
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  1. Permission Slip for Valentine’s Day Parents’ Night OutLiability WaiverI hereby give my permission for my child _______________________ to participate in the Valentine’s Day Parents’ Night Out event sponsored by the Madison St. Vincent de Paul Youth Service Council. I agree that I have provided Youth Service Council members with any allergy, medical or other important information regarding the health and safety of my child. I understand that should my child engage in aggressive/inappropriate behavior and/or fail to follow direction of the Youth Service Council members/other event chaperones present that I may be called to pick up my child and remove him/her from the event. I release and hold harmless the Society of St. Vincent de Paul; the District Council of Madison, Inc. –Society of St. Vincent de Paul; Sacred Hearts Parish; St. Bernard Parish; Youth Service Council members and other adult and teen chaperones from being held liable for any damages, fines, injuries, negligence, theft, legal fees, or previously unapproved expenses incurred or sustained by my child.___________________________________________________________________(signature of parent/guardian)(date)(phone #)_________________________________________________(second emergency contact person)(phone #)Photo ReleaseAs parent/guardian, I understand that promotional picturesand/or videos(individual and group) maybe taken during this event. I give permission for my son’s/daughter’s picture to be used for promotional materials (newsletter, presentations, Facebook updates, website) in highlighting the event and the Society of St. Vincent de Paul.________________________________________________(signature of parent/guardian)(date)(If using photographs/video of your child is not allowable, please also notify Youth Service Council members when your child arrives for the event.)Please list any allergies your child(ren) has(use the back of this formif necessary):Please list any medications your child(ren) is taking(use the back of this formif necessary):Please list any other helpful information for us to know about your child(ren):Thank you so much for supporting the YSC Ozanam Scholarship Fund through this event! If desired, your child can wear pajamas and bring blankets/pillow for watching the movie!
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