Howard Community College

Student Name (please print legibly) __________________________________________________ PARENTAL CONSENT/RESPONSIBILITIES Please check box to indicate that you have read these policies. Parent or Legal Guardian Signature* _________________________________________ Date* _________________ Parent/Guardian Name* (please print legibly) _________________________________________________________ I am the parent/legal guardian of the child named above. I have read the Kids on Campus policies and procedures and agree to the following:* I/We will abide by the policies and procedures of Howard Community College and Kids on Campus. Policies and procedures (pages 35-36) are subject to change. Refer to the Kids on Campus web page (howardcc.edu/koc) and howardcc.edu/coronavirus for the most up to date information. As of this printing in January 2022, masks are required and must be worn indoors except when eating. I authorize the release of my child's grade level and directory information to Howard Commu - nity College. This information is needed to verify either past or current enrollment in honors, gifted and talented, advanced placement, accelerated courses, or above grade level classes. This information will be submitted to the Maryland Higher Education Commission along with other enrollment data. I take responsibility for my child's compliance with appropriate student behavior. I understand that disruptive and inappropriate behavior will not be tolerated and will result in non-refundable dismissal. I acknowledge the risk of becoming exposed to COVID-19. I understand that the risk of becom - ing exposed to COVID-19 may arise regardless of the college's best efforts to implement and require compliance with prevention and mitigation measures. I acknowledge that the COVID-19 pandemic may evolve and that the college may need to take additional precautions to protect the health and safety of students, faculty, and staff. It is my responsibility to check the college's coronavirus web page at howardcc.edu/coronavirus for the latest information regarding college COVID-19 requirements. I/We understand and voluntarily assume all risks inherent in the nature of this activity and I/we waive and release all claims, costs, liabilities, expenses and judgements against Howard Com - munity College and release HCC and its representatives arising out of my child's participation in the activity at Kids on Campus. HCC and KOC are not responsible for personal items brought or left on campus. Electronic devices and cell phones may not be used during class hours without instructor permission. I take financial responsibility for my child's tuition and fee payment to HCC. I certify that I am registering a student for a Kids on Campus course and that the student has resided at the provided address with a parent or legal guardian for at least three months. I certify the information provided on registration and consent forms for the child named above is true and correct to the best of my knowledge. I understand that it is my responsibility to notify the Records Office of any change in contact information. Submit change of information form to the Division of Continuing Education and Workforce Development. Media Release I hereby give my permission and consent for Howard Community College ("the College") and its representatives to use my child's name, likeness, biography, voice, perfor - mance, written documents, or other content for purposes related to the mission of the College. The purposes include, but are not limited to, promoting, marketing, advertising, and commu - nicating about the College and any programs or services through websites, social media, television, or other communication channels. THIS FORM MUST BE SIGNED AND DATED TO BE OFFICIAL IN ORDER FOR STUDENT TO BE REGISTERED. Questions? Call 443-518-4110 or email koc@howardcc.edu. My child will be supervised after class according to Kids on Campus (KOC) dismissal policies unless the box below is checked. Other Dismissal Arrangements I take responsibility and give permission for my child to leave campus unaccompanied (bike, walk, bus, etc.) at dismissal.

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