Disclaimer Form (form)

Parent Permission and Authorization Form

Bal Vihar of St. Louis, MO

School Year 2014 - 15


I/We hereby give my/our consent for the student(s) named below to participate in Bal Vihar of St. Louis ("Bal Vihar’) school activities. I/We also consent to Bal Vihar using student pictures, activities etc. for advertising purposes. I/We also give my/our consent for him/her/them to participate in school activities and will not hold Bal Vihar responsible in case of an accident, injury or exacerbation of any medical/psychological condition. We hereby agree to hold the Bal Vihar school, its administrative staff, and volunteers harmless from any and all liabilities, actions, causes of action, debts, claims, demands of every kind and nature including losses of any kind whatsoever that may arise by or in connection with the participation by my/our child/children in any activities related to Bal Vihar program.

In no event shall Bal Vihar of St. Louis, MO be liable for any direct/indirect punitive, special incidental or consequential damage, however, it arises, whether for breach or in tort, even if Bal Vihar of St. Louis, MO has been previously advised of the possibility of such damage. I agree to hold Bal Vihar of St. Louis, MO harmless from, and I covenant not to sue Bal Vihar of St. Louis, MO for any claim related to Bal Vihar programs. I have been advised of potential food allergies to ‘prasad’ distributed by Bal Vihar and I accept ‘prasad’ at my own risk

Please note that it is the parent’s responsibility to arrange for bringing and picking up the student(s) to the school. If parent(s) arrange(s) for the student’s pick-up from the class room or the school, by a third party, without prior written & dated communication with the Parent’s Coordinator and classroom teacher, then Bal Vihar assumes no responsibility of Child after the class session is over.

Note: Parents are held responsible for the safety of participants and will promote safety of others too.