A parent or legal guardian signature on this form is required to participate in the Before & After Care Programs.

I verify that the information given for my child is complete and accurate.
For emergency treatment, I authorize the Seacoast Charter Before/After School Programs to arrange for transportation in case of accident or acute illness of my child. In the event it is not possible to receive instruction for my child’s care, consent is given to any licensed physician for treatment. I allow the physician to administer medication and to perform necessary treatment for the preservation of my child’s health and well-being. I understand that any cost incurred for treatment of sudden illness or accident shall be paid by me.
This authorization and consent for treatment is given to the Seacoast Charter Before/After School Programs’ staff in conjunction with any authorized event. General Release of Liability In consideration for being allowed participant privileges in any program of the Seacoast Charter Before/After School Programs, I hereby assume full responsibility for any risk of bodily injury, death, or property damage and/or while using the premises or any facilities or equipment hereon. I further agree to hold harmless the Seacoast Charter Before/After School Programs’ staff and volunteers from any and all claims that may result from any action for damages, including but not limited, to such claims that may result from injury or death, accident or otherwise, during or arising in any way from said activity.
I acknowledge that this General Release of Liability of the Seacoast Charter Before/After School Programs is binding on me and not my heirs, personal representatives, successors, and assigns.
Media Release: I hereby consent to the use of my child’s photograph taken in any Seacoast Charter Before/After School Programs’ activities for display purposes within the school or on the school website for the Seacoast Charter School.