DUNLAP EAGLES ROBOTICS TEAM – DERT 2040                             PERMISSION FORM

The team will be attending The Robotics Gateway Challenge at

Hazelwood Central High School

15875 New Halls Ferry Rd.

Florissant, MO 63034

Departure

Date

Sat, Oct 1, 2016

Time

4AM

Location

Outside DERT shop at Dunlap High School

Return

Date

Sat, Oct 1, 2016

Time

10pm, approx

Location

Outside DERT shop at Dunlap High School

Cost

$20 per student payable to DERT. Students should also bring money for a "fast food" dinner on Saturday and any snacks. Breakfast and Lunch will be provided.

Transportation

Mentors will be transporting groups of students in their personal vehicles

Notes

More event details can be found on this website: http://www.gatewayroboticschallenge.com/schedule.html

What to bring

DERT Shirt

$ for fast food dinner

Contact Information

You can contact Michelle Unser @ 309-363-9334

Please return this permission slip along with payment on Thursday, September 29, 2016.

I give permission for my child

to attend the DERT trip to the Gateway Robotics Challenge on

Oct 1, 2016

    My student will meet at DHS at 4AM to be transported by personal vehicle driven by a DERT Mentor.

    My student will meet the team at Hazelwood Central between 7:30 AM and 8 AM.

PLEASE CHOOSE ONE

Enclosed is $

20

to cover the cost of the trip. (Exact cash or check made payable to DHS-DERT.)

In case of an emergency, I give permission for my child to receive medical treatment. In case of such an emergency, please contact:

Name

Phone

Parent/Guardian Signature

Date