General Parents Permission

To: Officials of Hillcrest Lutheran Academy, Senior, and Junior High Schools.

1. The undersigned herewith grants ____________________________________________________ (name of student)

permission to participate in ALL school sponsored activities.

2. __________________________ May NOT participate in the following activities (please list): (name of student)

This agreement also authorizes such out-of-town trips as are necessary in pursuance of the above approved activities.

The undersigned understands that: The student is not covered by a school insurance policy and the parent or guardian is responsible for any medical bills incurred while the student is in attendance at Hillcrest Lutheran Academy.

“The undersigned hereby releases Hillcrest Lutheran Academy and the Church of the Lutheran Brethren of America and their respective officers, directors, agents and employees, from any liability from ____________________ ‘s visit permitted hereunder.”

“The undersigned understands that ____________________’s likeness may be photographed or videotaped by the school in the course of school activities. The undersigned hereby give consent for the school to use this child’s likeness in promotional and/or advertising materials.”

_____________________________ ___________________________________

Month Day Year Signature of Parent or Guardian