FOR THE RELEASE OF OFFICIAL AND CONFIDENTIAL INFORMATION -- I, the undersigned. am the parent or legal guardian of the child or student ("Child") named above and hereby authorize the Head of School and/or an admissions officer of Wellington, Columbus, Ohio, to request information of and receive from the present teachers, principal, or other persons or agencies in charge of "Child", any and all official and confidential records, files, health records, and other records of that type or kind, relating to "Child"; and the undersigned does release such principal, teacher, or other person or agency at the school where "Child" now is enrolled from any legal claim or liability which may exist from supplying to the said Wellington School any of the said records and materials.
NOTE: If there is more than one school from which official and confidential records are sought, set forth the additional name(s) and mailing information below.