Please complete the form below to give permission for your child to participate in LEAD 2020.

If you have multiple children attending, you will need to fill this form out multiple times (once for each child). We apologize for any inconvenience.

2020 Updated LEAD Parent Permission Form

Parents who registered children for LEAD 2020 prior to April 17 need to complete an updated permission form in order for their child to attend LEAD this summer.
  • By typing my name in the box above, I state the following:
     
      I, as parent or legal guardian of the named child do hereby give permission for their attendance of the Student Statesmanship Institute’s (SSI) LEAD Summer Program, at Cleary University in Howell during the summer of 2020, and further state that:
      • I am the parent or legal guardian of the named child and that I possess all the rights, powers, and privileges of a parent or legal guardian.
      • I personally assume, on my child’s behalf, all risk for any harm, injury, or damages that may befall my child or is caused by my child.
      • I give permission for my child to be transported to and from activities by hired and/or adult volunteer drivers.
      • I give permission to Student Statesmanship Institute to use my child’s photograph, video, oral and/or written comments to promote SSI and/or LEAD.
      • I agree to hold Student Statesmanship Institute, the owners and lessees of any premises used to conduct classes or activities, their sanctioning institutions, agents, officers, directors, and employees harmless and indemnify them from any injury, loss, damage, or claim of any nature arising out of or related to my child's participation in the classes and activities of LEAD, specifically including any negligent act or omission of the above.
      I have read and agree with all of the above and I support Student Statesmanship Institute in its endeavor to provide the best possible learning environment for every child. I acknowledge that this is a legal document and I will be bound by my agreement to its terms.

Office & Mailing Address:

SSI
4407 W. St. Joe Hwy.
Lansing, MI 48917
 
Phone: 517-321-6233
Email: ssi@ssionline.org