Waiver Of Responsibility
St. John School

 

Complete this form if you want your child to bring home your Scrip certificates in his/her backpack.  Your child will receive only the envelope of certificates ordered under your family I.D. number and name.  Certificates will jot be sent home with your child if you do not sign this waiver.  This waiver is for the school year of 2004 - 2005.

I authorize St. John School to release my Scrip certificates to my child.  I will not hold St. John School responsible for any lost or misplaced certificates.

Child's Name _______________________________________________

Grade _________  Teacher ____________________________________


___________________________________________________  Date: ____________________
                                      Parent Signature