1120 Commerce Avenue


Print/Parent’s/ Guardian’s Name: _____________________________ Home Phone No: ( )



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Print/Parent’s/ Guardian’s Name: _____________________________ Home Phone No: ( )_____________________



PERMISSION TO USE RABKIN PARK
There will be times during the 2017-2018 school year when students may have the opportunity to use the Rabkin Park, which is located directly behind the Hannah Caldwell School, for physical education classes and/or other activities during the school day. A signed permission slip from a parent/guardian is required before students will be permitted to participate in any of these activities.
Please sign the form and return it to your child’s teacher.
I give my child, _____________________________________________, permission to participate in any school sponsored activities at Rabkin Park during school hours during the 2017-2018school year.
________________________________________ ____________ ­­­­­­­­­­­­­­­­­­­­­­­­___________________________ ___________

Student’s Name (Please Print) Classroom # Signature of Parent/Guardian Date




PERMISSION TO HAVE NAMES AND/OR PHOTOS USED IN NEWSPAPERS AND/OR TV
Dear Parents/Guardians:
We will be submitting photographs, video tape, and stories to be printed in the local papers and/or Channel 34 during the school year. Please indicate whether or not we have permission to include your child in these photographs, tapes, and news stories.

Child’s Name: ___________________________

Parent/Guardian Signature: ______________________________________ Date: _______________
Check one:
_____Yes, I give permission
_____No, I do not give permission

PERMISSION TO TRAVEL TO OTHER UNION SCHOOLS
Dear Parents/Guardians:
There will be times during the 2017-2018 school year when students may have the opportunity to go to other schools in our district for musicals, plays, assemblies, introduction of instruments, Ex. (Union High School, Jefferson School, Connecticut Farms, etc.) A signed permission slip from a parent/guardian is required before students will be permitted to participate in any of these.
I give my child, ___________________________________, permission to participate in any school sponsored activities during school hours during the 2017-2018 school year.
______________________________ __________________________ ­­­­­­­­­­­­­­­­­­­­­­_________________________________

Student’s Name (Please Print) Classroom Teacher Parent/Guardian Signature




UNION TV34

INDIVIDUAL RELEASE AND AGREEMENT
DATED: ___________________
For and in consideration of being permitted to participate on a UNION TV34 PROGRAM, to be televised on COMCAST CABLE CHANNEL 34 & FIOS VERIZON 34 in UNION, NEW JERSEY, the undersigned Releaser, being of lawful ages, does for him or herself, his or her spouse, legal representatives, heirs and assigns, hereby release waive and discharge the TOWNSHIP OF UNION, their affiliates, agents, employees, successor or assigns, as the case may be (collectively, “Releasees”), of and from any and every claim, demand, action or right of action, of whatever kind of nature, either in law or equity, arising from Releaser’s participation as a guest on the aforementioned program.
Releaser specifically acknowledges and agrees that if Releaser brings a suit or claim for any reason relating to Releaser’s participation on a UNION TV34 PROGRAM, Releaser shall indemnify Releasees and bear all cost associated with Releasees’ defense of any such claim or action, including reasonable attorney’s fees and costs.
Furthermore, Releaser hereby grants Releasees the right and permission to copyright and/or use, reuse and/or broadcast and republish, videotape recordings of Releaser, or in which Releaser may be distorted in character of form, in conjunction with Release’s own or fictitious name or reproduction thereof, in color or black and white, made through any media by the TOWNSHIP OF UNION at its studio or elsewhere, for any purposes whatsoever, including the use of any printed material in conjunction therewith.
Releaser hereby waives any right to inspect or approve the finished videotape, sound track or advertising copy of printed matter that may be used in conjunction therewith or to the eventual use that it might be applied.
Releaser expressly agrees that the terms of this Release and Agreement are contractual and not a mere recital and that this Release and Agreement is intended to be as broad and inclusive as permitted by the laws of the State of New Jersey, and that if any portion thereof is held to be invalid, the balance shall, notwithstanding, continue in full legal force and effect.
Releaser has carefully read the foregoing Release and Agreement and understands the contents thereof and signs this release as his or her own free act.

I hereby certify that I am the Guardian of _________________________. a minor under the age of twenty-one, and in consideration of _________________’s participation on a UNION TV34 PROGRAM, to be televised on COMCAST CABLE CHANNEL 34 AND FIOS VERIZON 34 IN UNION, NEW JERSEY. I hereby consent to the terms of the foregoing Release and Agreement, with the same force and effect as if executed by me.

_________________________________________ ___________________________

Signature of Parent/Guardian Date

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