Acknowledgment of Liability Date MM slash DD slash YYYY Student's Name* First Last Parent's Name* First Last Email* I (we) understand and agree that any educator of HSPK, or employee or volunteer of Congregation Har Shalom, will not be held responsible for any accidental injury to my child while attending classes or school functions. I (we) take full responsibility for our child/ren before they are signed in for the day and greeted by a staff member. Directly after signing them out for the day, it is understood that I (we) are aware of the dangers associated with the parking lot and that I (we) will hold my (our) child once dismissed to an authorized adult. I (we) take full responsibility for my (our) child and any other children in my (our) care when I (we) am attending school events and family programs, regardless of a teacher’s presence.E-signature Acknowldgment* By checking this box, I acknowledge that I am electronically signing this document.Typed Signature* Δ
