WCES Club Permission Slip Form:

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Please fill out the information below to sign your child up for a club!

Email *

Student's First & Last Name/ El nombre del estudiante *

Parent First & Last Name/ Nombre del padre/tutor *

Parent phone number/ Número de teléfono (padre) *

Emergency Contact (First & Last Name)/ Contacto de emergencia *

Emergency Contact phone number/ Número de teléfono *

Student's Teacher/ profesor *

Please check the club(s) your child will be participating in: / Por favor marque el club en el que participará su hijo: *

Speed Stacking

Kindness Squad

Lady Wildcats (4-5th grade girls only)

Dance Team (starting after Christmas- 2nd semester)

Yearbook- 2nd semester (starting after Christmas- 2nd semester)

The Science Lab (3rd-5th graders only. Starting after Christmas- 2nd semster)

Required

Are there any medical needs we need to be aware of? If yes, please list any and all medical needs/allergies. / ¿Hay alguna necesidad médica que debamos tener en cuenta? Si, Necesidades médicas: enumere todas y cada una de las necesidades médicas/alergias a continuación *

Photo Consent: *

I grant Walnut Creek Elementary School permission to photograph my child while participating in club(s) indicated above. / Doy permiso a la Escuela Primaria Walnut Creek para fotografiar a mi hijo mientras participa en el club indicado anteriormente.

I grant Walnut Creek Elementary School permission to post photos of my child on their social media platforms to advertise clubs./ Le doy permiso a la Escuela Primaria Walnut Creek para publicar fotos de mi hijo en sus plataformas de redes sociales para anunciar clubes.

I DO NOT grant Walnut Creek Elementary School permission to photograph my child while participating in club(s)./ NO Doy permiso a la Escuela Primaria Walnut Creek para fotografiar a mi hijo mientras participa en el club indicado anteriormente.

I DO NOT grant Walnut Creek Elementary School permission to post photos of my child on their social media platforms. / NO Le doy permiso a la Escuela Primaria Walnut Creek para publicar fotos de mi hijo en sus plataformas de redes sociales para anunciar clubes.

Required

Please check off each statement below indicating your understanding of club expectations. *

I understand that all clubs will run from 4:15-5:15pm on the dates indicated (with the exception of Yearbook)/ Entiendo que todos los clubes funcionarán de 4:15 a 5:15 en las fechas indicadas (con excepción del Yearbook)

I understand that I am responsible for picking up my student at the conclusion of their club./ Entiendo que soy responsable de recoger a mi estudiante al finalizar su club.

I understand that if my child has any medical needs/concerns, they MUST be noted in the section entitled "Medical Information" above./ Entiendo que si mi hijo tiene alguna necesidad o inquietud médica, DEBE anotarse en la sección titulada "Información médica" anterior.

I understand that if my student is injured during one of the clubs listed above, I will hold Walnut Creek blameless. I understand that I will be contacted and that medically trained staff will tend to my student's needs until I arrive or provide permission for medical transport (if applicable). / Entiendo que si mi estudiante se lesiona durante uno de los clubes mencionados anteriormente, eximiré de culpa a Walnut Creek. Entiendo que se comunicarán conmigo y que personal médicamente capacitado atenderá las necesidades de mi estudiante hasta que yo llegue o proporcione permiso para el transporte médico (si corresponde).

I understand that clubs are a privilege and not a right and my child may be dismissed from a club at any given time due to misconduct./ Entiendo que los clubes son un privilegio y no un derecho y que mi hijo puede ser expulsado de un club en cualquier momento debido a mala conducta.

Required

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