EXTRA CURRICULAR                ACTIVITY PERMISSION SLIP

I,    _________________________________,  as parent/guardian, give permission for my child,

        Print name of Parent/Guardian

__________________________________, to participate in extracurricular activities under the

               Print student name

guidelines listed in the Watervliet City School District COVID-19 pandemic guidelines document, during the 2020-2021 school year, as well as agree to COVID-19 surveillance rapid testing in an effort to keep students/staff safe.

__________________________________                ___________________________________

            Signature of Student                                        Signature of Parent/Guardian

_________________________________