STATEMENT OF COOPERATION AND WAIVER OF LIABILITY
I recognize that attendance at Santa Rosa Christian School and Learning Center (referred to from this
point as SRCS) is a privilege and not a right. Parents are expected to cooperate with and support SRCS
and its teachers in the education and discipline of their child(ren) both in the classroom and during other
related school activities. I believe that discipline is necessary for the welfare of each student, as well as
for the entire school. I give permission for my child’s teacher and/or other agent of the school to make
and enforce classroom regulations in a manner consistent with Christian principles. Students shall forfeit
the privilege of attending SRCS if they do not conform to the standards and way of life at SRCS. SRCS
reserves the right to withdraw a student at any time that the student, in the opinion of and at the sole
discretion of the administration of SRCS, does not conform to the spirit of SRCS.
I further understand that SRCS policy prohibits refunds of all upfront school related fees.
In the event that a SRCS approved photographer or videographer takes a picture with my child in it,
either individually or in a group, I give permission for my child’s picture to be used in future brochures,
videotapes, DVDs, or other publications of SRCS or its affiliated ministries.
I further give permission for my child, whose name is set forth below, to take part in all activities,
including without limitation, transportation to and from school, gymnasium recreational activities, bus
trips, sports activities, field trips on the premises of SRCS and school sponsored trips away from the
SRCS campus. I indemnify and save SRCS, its affiliates, employees, and agents harmless from and
against any claims, demands, causes of action, liability, medical payments, costs and attorneys’ fees
resulting from or arising out of the participation by my child in the above-mentioned activities. I
understand that I am personally and fully responsible for any medical expenses or other liabilities over
and above the medical insurance provided by the third party insurance vendor used by SRCS.
I understand that should my marital status change, it is my responsibility to have a corrected Statement
of Cooperation and Waiver of Liability signed, updated, and delivered to SRCS.
This Statement of Cooperation and Waiver of Liability shall remain in effect for as long as my child
listed (or others to be enrolled) attends SRCS, whether it be in the Learning Center, elementary, middle
school, high school, or summer school. Any reference herein to “child” shall include and refer to all of
the children listed, or others to be enrolled in the future.
Children’s Names and Grades: Signature of Legal Parents/Guardian
___________________________________ Mother Date
___________________________________ Father Date
Sole Guardian Date
(Typed Name indicates Signature)
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