Liability Release Form (Page 2 of 2) in pdf

Liability Release Form Page 2

I have read the Release and Waiver of Liability form and fully understand its terms, and

understand that I, individually and as parent or guardian of my Student, have given up substantial

rights by signing it and have signed it freely and voluntarily. I intend my signature to be

complete and unconditional release of all liability to the greatest extent allowed by law.

________________________________________________________________________

Parent/Guardian Signature

Date

________________________________________________________________________

Parent/Guardian Name (printed)

Release Specific to the dispensing of over-the-counter medications

I do hereby give my permission to allow HCS to give my child ______________________

over-the-counter medications, including but not limited to, Tylenol, Benadryl, and/or Advil, as

deemed appropriate by the Administration Team.

Parent/Guardian Signature

Date

I do not give my permission to allow HCS to give my child ______________________________

over-the-counter medications, including but not limited to, Tylenol, Benadryl, and/or Advil, as

deemed appropriate by the Administration Team.

______________________________________________________________________________

Parent/Guardian Signature

Date

Page

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Liability Release Form Page 2