Reflections Help Session: Student After School Activity Permission Form & Waiver
What: Reflections Arts Program Student Workshop
When: Tuesday, November 19, 2024 3:20 pm - 4:20 pm (immediately after-school)
Where: Ms. Allen's Art Room. 
Students should be picked up in the car loop, and will need a guardian to sign them out at pickup
Who: All FRES students are invited! 
This event will be entirely staffed by parent volunteers; please be on-time in picking up your child. 
Parents are welcome to attend! If you would like to attend to learn more about the Reflections program or volunteer to help, please check in at the front office upon arrival.
How: Students must have this form completed by parents by 11/18 to be on the approved attendance list. 
At dismissal, students will report to Ms. Allen's art room. They can bring a simple snack with them to eat before the session begins. This session is FREE to attend.
Why: The PTA is offering an opportunity for students participating in this year's Reflections Arts Program to meet with other student participants to build camaraderie, support, and confidence! 
During the session, students will:
  • learn more about interpreting a theme in art
  • discuss the meaning of this year's theme with other students
  • have the opportunity to brainstorm and work on their project 
  • final work must be completed at home
Attendance is NOT required to participate in the Reflections Arts Program. Artwork submissions are due on Wednesday, December 4th.
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Email *
Student's First & Last Name *
Student Grade *
The above named student has my (our) permission to participate in the Reflections Arts Student Help Session after school on 11/19 and will be picked up at FRES promptly at 4:20 pm. *
Required
Guardian #1: First & Last Name *
Guardian #1: Preferred Phone Number while student is at session *
Guardian #2: First & Last Name
Guardian #2: Preferred Phone Number while student is at session

By my electronic signature, the undersigned parent or guardian acknowledges that all activities include some inherent risks. I (we) hereby release and discharge the Free State PTA and Forest Ridge PTA Unit, and all PTA officers, and agents from all liability, claims or demands for any damage, loss or injury to the student, the student’s property, or parent’s property in connection with participation in these activities, unless caused by the negligence of the PTA. 

 *
Required
I do hereby certify that to the best of my (our) knowledge and belief said minor is in good health. In case of illness or accident, permission is granted for emergency treatment to be administered. It is further understood and agreed that the undersigned will assume full responsibility for any such action, including payment of costs.

I (we) hereby advise that the above-named minor has had the following allergies, medicine reactions or unusual physical condition which should be made known to a treating physician or which could limit participation. (If none please write “none”): 
 *
Requested or needed accomodations?
First & Last Name of anyone else approved to pick up student?
Contact Information of additional approved person?
Please type your name in the box below to confirm your consents for your listed legal dependent: *
A copy of your responses will be emailed to the address you provided.
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