SLC/Pace Make a Difference Signup Form

"SLC/Pace Makes a Difference Day"
Saturday October 19th
11:00am - 1:00pm at 50 Broadway, Hawthorne

Attendee Name

Food Allergies/Additional Information

Emergency Contact Telephone

Email Address

I plan on attending the SLC/Pace Makes a Difference Day!

I am an SLC Student.

I am a Pace Student.

I will try to bring can or dry goods to support the Food Drive.

I give permission to photograph for social media or promotional use.

How many people are planning on attending with you?

I acknowledge that attending any SLC class/club/event (the “Event”) may involve certain risks (some of which I may not be fully appreciated at the time of signing) and that injuries, death, property damage or other harm could occur to Student or others. In exchange for the consideration granted by SLC in attending the Event, I voluntarily accept and voluntarily incur all risks, waive and forever discharge all claims whether known and unknown, and agree to release, indemnify, defend and hold harmless SLC and the Premises, including their respective officers, directors, employees contractors, shareholders, members, agents, affiliates or insurers (the “Released Parties”) for any injuries, damages, or harm which arise during or result from participation in the Event, regardless of whether or not caused in whole or in part by the negligence or other fault of the Released Parties.

I acknowledge and agree that in the event of a breach or any of your obligations under these Guidelines, SLC in its sole discretion, may refuse Student's admission to class/club/event and/or cancel Student's enrollment in the SLC program thereby terminating this agreement. The SLC reserves the right, at its discretion, to refuse or withdraw a student from the program at any time, for any reason. You may not assign any of your or Student's rights or obligations hereunder, whether voluntarily or involuntarily without the SLC's written consent.

That SLC in its sole discretion, may refuse Student's admission to the Class and/or cancel Student's enrollment in the SLC program. I understand the SLC may refuse to allow a student to attend.

Student/Parent/Guardian Signature

Student/Parent/Guardian

I have read, understand and agree to the risks in attending the Event.

I can't wait to play Fall bingo and corn hole, compete in a Mummy wrapping contest, have cider and donuts, create marble pumpkins for my community and donate to the food drive!

Thanks for the RSVP, we can't wait to see you there!

SLC

"SLC/Pace Makes a Difference Day" Saturday October 19th 11:00am - 1:00pm at 50 Broadway, Hawthorne

"SLC/Pace Makes a Difference Day"
Saturday October 19th
11:00am - 1:00pm at 50 Broadway, Hawthorne