Home | Student Empowerment Conference Participation & Release Form STUDENT PARTICIPATION AND PHOTO RELEASE FORM Event: Student Empowerment Conference Organizer: SAR High School Date of Event: Tuesday, April 1, 2025, 8:30am-1:45pm Location: SAR High School, 503 West 259th Street, Bronx, NY Student Information:(Required) First Last Email:(Required) School:Grade:(Required)Are you 18 or Older?(Required) Yes No Parental/Guardian Consent for Participation and Photo Release(Required)I, the undersigned parent or legal guardian of the above-named minor, grant permission for my child to participate in the Student Empowerment Conference organized by SAR High School. I understand that this conference may include discussions on historical and contemporary issues related to antisemitism and is intended for educational purposes. I acknowledge that students from multiple schools will also be in attendance and that my child’s participation is voluntary. I understand that reasonable efforts will be made to ensure a safe and respectful environment during the event. Furthermore, I consent to SAR High School and its representatives taking photographs and/or video recordings of my child during the conference. I authorize the use of such photographs/videos for educational, promotional, or informational purposes, including but not limited to school publications, websites, social media, and news media coverage. I understand that my child’s name will not be used in connection with any photos or videos without additional consent. I acknowledge that I have read and understood this release form and voluntarily agree to its terms.Parent / Gaurdian Information:(Required) First Last Relationship to Student:(Required)Parent / Guardian Email:(Required) Signature(Required)Date(Required) MM slash DD slash YYYY For Students Age 18 or Older(Required)I, the undersigned, acknowledge that I am 18 years of age or older and consent to my participation in the Seminar on Antisemitism. I also grant permission for photographs and/or video recordings of me to be used for educational, promotional, or informational purposes as outlined above. I acknowledge that I have read and understood this release form and voluntarily agree to its terms.Signature(Required)Date(Required) MM slash DD slash YYYY Emergency Contact Information:(Required) First Last Phone Number:(Required)Relationship:(Required)
