Parental/Guardian Consent Form and Liability Release

*You must accept the terms of this statement in order for your student to participate at St. Augustine HSE.

I grant permission for my child(ren) and/or minors in my care to participate in activities at St. Augustine HSE.

I agree on behalf of myself, my child(ren), and my family and representatives, to hold harmless St. Augustine HSE: its officers, directors and agents, and other representatives, from any and all actions, claims, demands, damages, costs, expenses and all consequential damage arising from or in connection with my child(ren) and/or any minors in my care attending the event or in connection with any illness, injury, disability, death, or cost of medical treatment in connection therewith.

In the event of an emergency, I hereby give permission to administer emergency treatment and/or to transport my child(ren) and/or minors in my care to a hospital for emergency medical or surgical treatment.

I understand that my child may appear in group photos on the St. Augustine HSE website.

I acknowledge that this release waiver is intended to be as broad and inclusive as permitted by the law of the State of North Carolina and that if any portion thereof is held invalid, the balance shall continue in full legal force and effect. I accept; this constitutes my signature
I do not accept; my family will not participate