The Addams Family Summer Musical Parent/Guardian Authorization Form
The EVSC Foundation & EVSC requires that emergency contact information be provided prior to a student's participation.
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Student's Legal First Name *
Student's Legal Middle Name *
Student Last Name *
Student ID# *
If None please put N/A
Date of Birth *
MM
/
DD
/
YYYY
2022-23 Grade *
Select one
Street Address *
City *
State *
Zip *
Home Phone *
Cell Phone *
Cast/Crew/Orchestra *
Student email *
personal or EVSC
Gender *
Ethniticity *
Current School *
2022-23 School Year
School Counselor *
School Counselor email *
Parent / Guardian
Parent/Guardian Name *
Relationship to Student *
Contact Phone # *
Parent / Guardian
Name *
Relationship to Student *
Contact Phone# *
Emergency Contact Information
Emergency Contact's First and Last Name *
Can NOT be parent or legal guardian.
Emergency Contact's Relationship to Student *
Emergency Contact's Phone Number *
555-555-5555
Authorization
Permission to treat/participate/media *
Do you grant treatment, participation, and media authorizations for your student?
Full Name of Person Granting Authorization *
Relationship to student *
Electronic Authorization *
First 4 letters your last name AND 2 digit month and 2 digit year of your birth (e.g., Smit0259)
Submit
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