Fields marked with an * are required

For your convenience, you may complete this online authorization and release of liability form in lieu of submitting the paper-form.

 

Child's information

Parent/Legal Guardian's Information

Please read and review TECC's Summer 2019 Policy before completing this form.

Please read the terms and conditions of each Authorization and/or Release of Liability clause and check all boxes.

Authorization of Photo Release

I authorize Temple Education Center Corp (TECC) to use the student’s image, voice, and performance by any and all mechanical, electrical, digital, and photographic means in connection with the student’s attendance of the camp. The undersigned consents to and irrevocably grants to TECC the perpetual right to use, reproduce, exhibit, edit, and exploit the released material into any and all media now known or hereinafter devised and understands that this material is the sole property of TECC.

Authorization for Medical Treatment

I authorize TECC to obtain emergency medical treatment when necessary in the opinion of the school. This authorization is valid until revoked by me in writing. I will hold TECC harmless from any liability which might arise from authorizing medical treatment. I authorize TECC to administer to my child over-the-counter medication and medication as prescribed to my child by a licensed physician. I agree not to hold liable TECC and TECC employees for medical aid rendered and will reimburse TECC for all medical or other expense incurred in the care of my son/daughter. I understand in case of an emergency, hospital and medical costs for my child will be my sole responsibility.

Release of Liability

I agree to release and hold harmless TECC, its agents, representatives, administrators, managers, employees, related entities, and trustees from all claims, damages, or other liabilities for injuries to my child which are not the result of willful misconduct by TECC, its agents, representatives, administrators, managers, employees, related entities, or trustees. I further agree to indemnify TECC for damages to property by my child. I hereby release, waive, and discharge my right to pursue legal action against TECC and its employees from all liability to my child on the account of injury to the person or property of, while my child participates in field trip.

Authorization for School-Sponsored Field Trips

I give my permission for my child to participate in all field trips sponsored by TECC. For the purpose of this authorization, any trip away from school shall be considered a field trip. This authorization is valid until revoked by me in writing. Transportation will be arranged as deemed necessary by the school.

Authorization for Sunscreen Application

I authorize TECC to apply sunscreen to my child. I agree that neither TECC, nor any of its employees, will be held liable in any way for any injury, loss or damages arising out of or resulting from administration of the sunscreen.

Food Allergy Policy

I have read and understand the Food Allergy Policies. I understand that there are health risks involving food allergies for my child. I understand that, despite precautions, my child's class and school environment may not be 100% nut/allergy free and safe for my child. I understand that TECC will take all reasonable steps to ensure that the class is safe for my student, but there is no guarantee. On behalf of myself and my child identified above, I hereby release, waive and discharge TECC and its teachers, employees and agents from any and all claims, liability, damages or relief related to my child's consumption of or exposure to food and allergens and applying epi-pen or other mediation to my child while at school or on a school-sponsored activity.

TECC Summer Policy

I have read and understand the TECC Summer 2019 Policy and Authorization. By signing this form, I agree to abide by all terms and conditions as set forth in the TECC Summer 2019 Policy, and I agree to authorize all items listed in the TECC Summer 2019
Authorization. I also understand that I am obligated to pay for the days and times for which I enroll my child and need to pay in full the fees before the TECC summer session starts.