National Honor Society Service Verification Form

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Student Name ________________________________________
NATIONAL HONOR SOCIETY SERVICE VERIFICATION FORM: In consideration of the opportunity for the student listed below to
participate in the National Honor Society service program and fully recognizing that such an undertaking involves an element of risk, I assume
all risks and hazards incidental to such participation and do hereby release, absolve, indemnify, and agree to hold harmless O’Gorman High
School, its agents, employees, organizers and sponsors. *Parents must sign the verification form prior to the beginning of any service work.*
__________________________________________________
*Signature of Parent/Guardian
*Parents must also initial the verification form prior to the beginning of any service work.
Supervisor’s
Parent
Date
Location
Description
Hours
Supervisor Signature
Initials
Phone #
I have fulfilled the above National Honor Society Service hours to the best of my ability and in accordance with the guidelines outlined in the
NHS requirement packet.
_____________________________________________________________
Student Signature

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