General Release Form Date MM slash DD slash YYYY Student's Name* First Last Parent's Name* First Last Email* Consent I give permission for my child to be photographed and videotaped. I understand that these photos/videos, along with my child’s name, may be used in the classroom as well as appearing in newspapers, on our website, or other publicity. In the event of a minor emergency, I authorize the staff of HSPK to administer first aid to my child. I give permission for my child to participate in field trips as listed on my child’s lesson plan. I give permission for the staff at HSPK to administer medication to my child. I understand that only medication that I provide in its original container will be given. I also understand that a written prescription from my child’s physician is required. I give permission for the staff of HSPK to share information in matters related to the health, safety, education and best interest of my child, as well as statistical information required for funding. I herewith release HSPK from any and all liability to me for supplying such information. I give permission for the staff of HSPK to assist my child with diapering and toileting needs. I will supply wipes or other special needs associated with toileting.E-signature Acknowldgment* By checking this box, I acknowledge that I am electronically signing this document.Typed Signature* Δ
