Syllabus Signature Page for Mrs. Miranda's Class Semester One
This form contains necessary information for your student's PE teacher. AFTER you have read the BOTH syllabi (PE Department's AND Mrs. Miranda's) please fill out the following
What Period does the student have PE? *
Student's Name (Last, First) *
Emergency Contact Information *
In case student is hurt during class, WHO (person's name) should the school contact?
Emergency Contact Phone Number *
Parent/Guardian E-mail address *
Medical Information
Please list any medical conditions that your child has that might effect his/her ability to participate in Physical Education. Written verification from a doctor may be necessary. Please make sure the nurse is aware of any medical conditions.
Parent/Guardian Signature *
By typing your name, you agree that you have read and understand the PE Department's syllabus AND Mrs. Miranda's High School Course 1 & 3 Syllabus. If you have any questions, please contact Mrs. Miranda.
Student Signature *
By typing your name, you agree that yo have read and understand the PE Department's syllabus AND Mrs. Miranda's High School Course 1 Syllabus. If you have any questions, please contact Mrs. Miranda.
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