Basic Permissions

Today's Date

YYYY

Student's First and Last Name

First Name

Last Name

WATER PLAY

I understand that on occasion, swimming and/or water play are part of certain field trip activities.

Is your child able to swim?

Are there any special provisions that should be taken to ensure your child's safety in the water?

PHOTOGRAPHY/IMAGE USE

I consent to INTERNAL image use of my child as detailed below:

I give permission for my child to be included in any image recording connected with the school’s program which is purely intended for internal purposes. This might include posting to the internal-facing Facebook account, internal-facing Instagram account or ALC blogs that are intended to be shared with those inside the Heartwood ALC community. Please be aware it is possible that these forms of media may also be posted on the Internet at-large without the permission of Heartwood ALC.

I consent to EXTERNAL image use of my child as detailed below:

I give permission for my child to be included in any image recording connected with the school’s program, specifically external-facing media. This might include postings to the external-facing Facebook account, external-facing Instagram account or ALC blogs that are intended to be shared with the ALC community worldwide. I understand that those images may be used as documentation on the school’s website, newsletter or marketing materials.

MEDIA CONTENT RATINGS

Please select the highest movie/ show/ games rating that applies to your student

Movie: G --- SHOWS: TV-Y-7 ---- GAMES: E (Everyone)

Movie: PG --- SHOWS: TV-PG ---- GAMES: E10 (Everyone 10+)

Movie: PG-13 --- SHOWS: TV-14 --- GAMES: TEEN

Movie: R --- SHOWS: TV-MA --- GAMES: MA (17+)

Movie: NC-17 --- GAMES: AO (Adults only)

LEGAL PERMISSIONS: Once you fill out this bottom portion and press 'SUBMIT,' Signrequest will send you a form called "Legal Permissions and Caregive Agreements" directly to the email you list below. The Signrequest form is a legal document so requires signature.

Parent/ Guardian 1 Name

This tells our automated system who to send forms to for signature

First Name

Last Name

Parent/ Guardian Email

This tells our automated system where to send the next forms for signature

Our application has several pages, so please remain in your browser window after clicking “SUBMIT” on this and each page following. Your last page of the application will be submitting a tuition offer. We look forward to learning more about you!