2019 Freshman Agenda Program - Permission/Registration Form
(Orientation Program for Rising 9th Graders)
Student's Last Name *
Your answer
Student's First Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian E-mail Address *
Your answer
Student's Allergies/Medical Conditions/Medications (if applicable)
Your answer
I grant permission for my son/daughter to receive medical or hospital care if needed. *
I agree to hold harmless Lawrence High School and Lawrence Township Board of Education, its employees and agents, against any claims or liability arising from personal injury or property damage incurred by my son/daughter. *
Parent/Guardian Electronic Signature (By clicking YES below you certify that information provided above was correct at the time form was completed.) *
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