CA State PTA Student Participation Waiver for Arroyo
Please complete one waiver for EACH CHILD for participation in any PTA sponsored events (includes but not limited to the school Variety Show, Daughter and Loved-One Dance, Son and Loved-one, Choir, Carnival, 5th Grade Finale) for the 2018-2019 school year (Families with multiple children will fill out a waiver for each child).
Student's Last Name
Student's First Name
Student's Date of Birth:
Does the above listed minor have allergies, medicine reactions or unusual physical conditions which should be made known to a treating physician.
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