Visitor Form

VISITOR’S NON-DISCLOSURE AND WAIVER AGREEMENT

I understand the right of each student and their family to confidentiality and agree to comply with state and federal law, and The ELIJA School policy regarding confidentiality of student information. My signature indicates I will not at any time communicate in oral or written form information obtained about any student as a result of my visit without the written consent of the parent/guardian. My failure to comply with this agreement will jeopardize all future visitations. During my visit to your facility, I may learn and/or have disclosed to me proprietary or confidential information (including, without limitations, student information or records, curriculum, information relating to technology, trade secrets, processes, materials, equipment, drawings, specifications, prototypes and products) (hereinafter collectively called “Confidential Information”). In consideration of your permission for me to visit The ELIJA School and for the courtesies extended to me during my visit:

I agree that I will not, without the written permission of The ELIJA School, either; Disclose or otherwise make available to others any Confidential Information deliberately or inadvertently disclosed to me during this and any subsequent visit; or *

Use or assist others in using or further developing in any manner any confidential information. *

Use cameras or video technology to disclose confidential information. *

I also agree to conform to any applicable safety requirements, which are brought to my attention by any employee or by signs posted in the areas that I visit while on the premises, and to observe other reasonable safety precautions. *

I further agree to release The ELIJA School’s officers, agents, employees, invitees or licensees from all claims, losses, expenses (including attorney’s fees), interest, damage and liability to the extent caused by or resulting from my negligence or willful misconduct. *

By signing into the facility, I acknowledged and understand the Visitor Guidelines and Non-Disclosure Agreement set forth above. *

Upcoming

Special Events

ELIJA Farm Fall Festival 2023

Long Island Behavior Analysis Conference 2023

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