CA State PTA Student Participation Waiver for Arroyo
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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 *
Your answer
Student's First Name *
Your answer
Student's Date of Birth: *
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Student's Grade *
Student's Teacher *
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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