Signature of Participant Date Sample Clauses

Signature of Participant Date. SECTION 6 ‐ TRUSTEE APPROVAL I, the authorized Plan Representative, certify, under penalties of perjury, that based on the Plan Sponsorʹs records, the number shown on this form is the correct taxpayer identification number (Social Security Number) of the Participant and that the Participant is a U.S. citizen (including a U.S. Resident Alien). I also certify that the above information is complete and correct.
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Signature of Participant Date. Signature of Legal Guardian (if participant is under 18 years of age) Date NOTARY PUBLIC State of Texas, County of Before me on this day personally appeared , the person whose name is subscribed to the foregoing instrument and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed. Given under my hand and seal of office this day of , .
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Signature of Participant Date. If from same immediate family, additional ADULTS may acknowledge this Agreement and sign below (this Agreement is not to be signed by participants who are 17 years of age or younger): Name of Participant (Please Print) Signature of Participant Name of Participant (Please Print) Signature of Participant
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Signature of Participant Date. As a legal guardian of , I consent to the above terms and conditions. Signature of Parent / Guardian Date
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Signature of Participant Date. If student is under the age of 18, the signature of a parent or guardian is required below. I certify that I have read this form, understand the provisions thereof and agree to be bound hereby. (Both Parents or Guardians must Sign if Applicable) Name of Parent or Guardian #1 (please print) _______________________________________ _______________________________________ Signature of Parent or Guardian #1 Date Name of Parent or Guardian #2 (please print) _______________________________________ _______________________________________
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Signature of Participant Date. I (a) am the parent or legal guardian of the above student; (b) have read the foregoing Assumption of Risk and Release Form (including such parts as may subject me to personal financial responsibility); (c) am and will be legally responsible for the obligations and acts of the student as described in this Assumption of Risk and Release Form, and (d) agree for myself and for the student to be bound by its terms.
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Related to Signature of Participant Date

  • Participant Signature Ratification, Acceptance(A), Approval(AA), Accession(a)

  • Employer Signature Employer hereby agrees to this Salary Reduction Agreement. Signature of Employer Representative Date

  • Employee Signature Employee ID: Telephone No: Employee Address: Work Location:

  • Number of Participants 4. The Grantee shall establish written policies and procedures governing all State Aid Commitment Diversion programs and services Grantee provides.

  • EMPLOYEE SIGNATURES Signature: Phone # / Personal E-mail: Signature: Phone # / Personal E-mail: Signature: Phone # / Personal E-mail:

  • Signature Signature For the participant For the institution Xxxxxx Xxxxx prof. Ing. arch. Xxxxxx Xxxxxxx, PhD. Vice-xxxxxx for International Relations and Public Relations, based on the procuration Annex I

  • Participant Agreement I understand that as a condition for participating in the Program I must comply with the Program’s rules and standards of conduct and follow all reasonable direction of the Program Staff. Failure to comply with the Program’s rules and standards of conduct or failure to comply with the reasonable direction of Program Staff may result in my being dismissed from the Program. Participant Signature: Date: PARENT/LEGAL GUARDIAN AGREEMENT I understand that my child will be subject to the rules and standards of conduct of the Program, Valdosta State University and the University System of Georgia. I further understand that my child’s violation of the rules and standards of conduct or failure to comply with the reasonable direction of Program Staff may result in my child’s dismissal from the Program. I accept responsibility for all costs associated with removing my child from the Program, including but not limited to transportation costs to return the Participant home. I understand that Dismissed Participants are not eligible for a refund of any fees or expenses. Parent/Guardian Signature: Date:

  • Multiple Individual Retirement Accounts In the event the depositor maintains more than one Individual Retirement Account (as defined in Section 408(a)) and elects to satisfy his or her minimum distribution requirements described in Article IV above by making a distribution from another individual retirement account in accordance with Item 6 thereof, the depositor shall be deemed to have elected to calculate the amount of his or her minimum distribution under this custodial account in the same manner as under the Individual Retirement Account from which the distribution is made.

  • Part-Time Unit Members Except as otherwise specifically provided in this Agreement, the following Articles shall apply to part–time faculty and professional unit members: Preamble Article I Recognition and Definitions Article II Relationship between the Association and the Employer Article II–A Special Joint Study Committee Article III Use of Employer’s Facilities

  • Years of Service (i) A Participant’s Years of Service shall include all service performed for the Employer and ¨ Shall ¨ Shall Not include service performed for the Related Employer.

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