Rosary High School - High Endeavors

Last Name:
Parent`s First Name:
Address:
City:	, IL
Zip:
Home Phone:	Cell Phone:
*Select 1 (ONE) as your directed earning:*
	Rosary Tuition Student`s Name: Class of :
	Professional Development (staff)
	Guardian Angel Scholarship Fund
	College:
Student Order Program Waiver
In signing this waiver I agree to be part of the Rosary High School High Endeavors Program. I have read and agree to the Guidelines & Policies of the High Endeavors Program and Student Order Program. I understand that once the gift certificates are given to the student, I assume all responsibility. In registering for this program I have been made aware of the possible consequences. Gift certificates have a cash equivalent and if lost or stolen cannot be replaced, traced, or refunded. I will not hold Rosary High School, the High Endeavors Program or any of its volunteers responsible for lost, misplaced or stolen certificates. Student authorized to participate in the Student Order Program:
Family Name: Date:
Signature of Parent: ______________________________________
Signature of Student: _____________________________________
Email Address :
Please print out this form, sign if applicable, and return to the school office.