Parent/Guardian Signature
I give permission for the above named student to participate in the 21st CCLC Summer Enrichment Program. I understand that by signing this registration form that my child will attend the program Mon-Fri (10am-4pm) for the weeks selected. 21st CCLC staff will provide proper supervision. It is agreed that my child will abide by all rules and regulations of the Anchorage School District and follow all safety guidelines while handling and using tools to complete activities. I understand that if my child, for any reason, fails to abide by all rules and regulations; disciplinary steps will be taken, which may include dismissal. I also grant permission for my child to participate and appear in video or audio recordings, films, photographs, written articles, and on website. I understand my child may be transported by bus and the schedule will be provided to me in the confirmation packet. I consent to any emergency transportation, medical treatment, care or hospitalization deemed necessary while he/she is participating in the above stated activities. I understand the district will assume no liability or cost for such emergency transportation and medical treatment. I also understand that insurance coverage is my responsibility.