2010-2011 KENWOOD ACADEMY H.S. CONCERT CHOIRCONSENT & LIABILITY RELEASE FORM

I/We , Parent(s) or Guardian(s) of , understand and agree with the purpose of the Kenwood Academy Concert Choir 2010-2011 Concerts, Field Trips, Fund-raising Activities and Educational Tour, hereby give my son/daughter permission to participate in these activities.

I/We represent that , has complied or will comply with all responsibilities and requirements necessary to actively participate in these activities.

I/We, as the parent(s) and or legal guardian(s), agree to and do authorize the Chicago Public Schools (CPS) and its chaperones or individuals designated by CPS, to act for me/us in an emergency, accident or illness and further agree that the adult chaperones or such designated individuals shall not incur any liability for taking such action.

I/We agree that the Chicago Public Schools (CPS) has the right to terminate 's participation in these activities for any behavior deemed detrimental to these activities or fellow student(s).

I/We agree that, will travel according to the travel plans made by the Chicago Public Schools (CPS) and I/we will not expect an exception to be made for , due to an unforeseen event, personal or family circumstance which prohibits the ability to comply with the travel plans made by Kenwood Academy Concert Choir or its representatives.

I/We affirm that has no chronic condition or disability of which Kenwood Academy High School, Kenwood Academy staff or personnel, Local School Council, the Board of Education of the City of Chicago (CPS) and all its agents, employees or representatives have not been made aware of; or that has not been indicated within medical records provided to the Chicago Public Schools (CPS), which would make participation in these activities inadvisable.

I/We further release, myself/ourselves, my/our heirs, executors, administrators and do hereby waive and release any and all rights, claims and causes of action whatsoever I/we may have now or in the future against Kenwood Academy High School, Kenwood Academy staff or personnel, Local School Council, the Board of Education of the City of Chicago (CPS) and any of its agents, employees or representatives for any matter, cause or thing whatsoever in which participates relative to these activities.

I/We give consent for the use of 's photographs, audio-tapes, videotapes, and/or interviews for publicity purposes or use in these activities and media publication without compensation.

I/We give consent for the use of the contact information listed on the KCCP Parent & Student Network/Volunteer Form for informational distribution purposes in which (KCCP) may contact my son/daughter and I/We via telephone, SMS messaging, email and US mail.

I/We hereby accept the responsibility to pay for the Kenwood Concert Choir activity fee(s), fund-raising items and all other classroom fines attributed to the account of my son/daughter in the instance I choose or fail to participate in fund-raising activities set forth to compensate the cost of activity fee(s) or my child fails to comply with the rules and guidelines required to participate in this choir (i.e. - performance protocol, behavior, uniform compliance, etc.). I also understand that if I choose to not enroll my child beyond the first grading quarter, that I will automatically become responsible for paying 75% ($375) of the Student Activity Fee.

I/We understand that I/we are signing this document in addition to, and not in replacement or exclusion of any and all other forms and agreements required by the Chicago Public Schools (CPS).

I/We agree that the Chicago Public Schools (CPS), Kenwood Academy High School, Kenwood Academy staff or personnel reserves the right to change or alter travel or other arrangements should conditions necessitate.

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