Ascension Scrip Registration Form and Waiver

First Name		Last Name
Street Address
City	State		Zip
Phone	E-Mail

I have read and understand the policies and guidelines on the previous page and I agree to abide by these policies

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Signature Date

If you wish to have a child bring home the Scrip cards, you must have the following waiver signed and sent back to school. If this is not signed, the Scrip cards cannot be sent home with a child.

I, _____________________________________, give permission to Ascension Catholic School to deliver Scrip cards which I have ordered and paid for from ACS to my child, ________________________________________.

I understand that this child will be responsible for the safe transport of the Scrip from school to my home and certify that I have discussed the responsibilities associated wht the transport of the Scrip with my child. I further understand that I have the option of personally picking up my scrip orders from the school office.

I agree that once ACS delivers the Scrip to this child that the school is not responsible for any scrip that is lost, stolen, or misplaces. I hereby waive any right of recovery that I may have against ACS for Scrip that is lost, stolen, or misplaces after it is given to this child.

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Signature Date