Parent or Legal Guardian Permission: I have the legal authority to sign-up the child on this application and that to the best of my knowledge the information on this application is complete and accurate. I further understand that this is an application and the named child’s participation is contingent upon space being available in the program in which I want the child to participate. I also understand that once my application is confirmed, I must complete payment (s) by the deadlines of the program. Furthermore, all necessary forms and waivers must be signed on file with the Literacy Council prior to my child attending the program. Failure to comply with the above could result in loss of space in the program.
Parent Authorization: I herby do declare my child to be physically sound and provide consent for my child to participate in the Literacy Council of Southwest Louisiana’s (Literacy Council) Summer Enrichment Program. The health history provided is correct so far as I understand and the child named above has permission to engage in all activities except as noted. I further understand that neither the Literacy Council’s paid staff nor volunteer workers can be held responsible in the event of an accident.
Summer Enrichment Program Activities: I hereby give permission for my child to participate in Summer Enrichment Program activities and to participate in walking field trips to the local library or nearby points of interest. I understand that Summer Enrichment Program staff will provide supervision for all such activities. I agree to release the Literacy Council, its officers and directors, and the SEP staff from any and all claims of damages, demands, or liabilities which may arise as a result of my child’s participation in camp activities.
Emergency Authorization: I hereby give permission for the Literacy Council to seek medical assistance in the event of an emergency. I authorize permission for my child to receive treatment as prescribed by hospital emergency room staff. I will be fully responsible for any costs of such treatment, even if not covered by my insurance.
By entering the security phrase below and selecting "submit", I agree to payment of the non-refundable registration fee and all terms and conditions outlined in the Parent or Legal Guardian Permissions, Parent Authorization, Summer Enrichment Program Activities and Emergency Authorization clauses.