SCHOOL NAME: ______________________

CITY & STATE: ________________________















MAIL TO:
National Academic Association
1540 Siesta Dr.
Sandy, UT 84093

STUDENT GENERAL RELEASE

KNOW ALL MEN BY THESE PRESENT: I, the undersigned, for the purpose of enabling ____________________________ (student's full name), a minor, to participate in the National Academic Championship and all related activities, do hereby release the National Academic Association, Questions Unlimited, Hilton DFW Lakes Resort, Marymount University, Holiday Inn, and their employees, representatives, or agents and all representatives or agents involved with the said academic championship as follows:

  1. 1. All are hereby released from any and all liability or claims, present or future, known or unknown, of every kind, character, or description, that may be created by or arising out of, either directly or indirectly, said academic championship and all related activities.
  2. In event accident, injury, or illness necessitates medical attention, our school's faculty sponsor(s), advisor(s), or representative(s) is specifically authorized and given sole discretion to obtain such medical attention at such place or places and from such person or persons as their sole judgment shall determine necessary.
  3. All are authorized and given sole discretion to administer such disciplinary actions as may be determined necessary, including but in nowise limited to the authority to return said student home at any time during the duration of the academic championship and all related activities. I hereby acknowledge that I will be financially responsible for any damage to property or persons resulting from the actions of said student while a participant in the National Academic Championship.
  4. I hereby authorize the National Academic Association to make or use a picture of said student, to be exhibited by means of the Internet or by any other means of exhibition.


I have read and understand its terms. I execute it voluntarily with full knowledge of its significance, and with the intention of binding myself.

Dated this ______ day of ___________, 2008
__________________________


___________________________
Father or Legal Guardian


Mother or Legal Guardian
_________________________________________________________________
Home Address
__________________________________________________________________
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