Behavior Form

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Behavior Form

This form will generate a pre-filled PDF document with your responses that will be e-mailed to you. Please print the document, review, sign, and return to Mr. Gregoric by the deadline. The e-mail you enter below is the address the pdf document will be sent, and also recorded as the parent's contact e-mail.
For purpose of this document "Trip Staff" includes the Music Director, SMUHSD Nurse/Staff, and Chaperones.

Email *

Student First Name *

Student Last Name *

Student Cell *

This number will be used by the Music Director and Chaperones to contact the student during the trip. ###-###-#### format. If not supplying cell phone number, please type "none"

Cell Use Consent *

The ability for Trip Staff to contact your student during the trip is important to keep everybody safe while giving some freedom to explore in small groups without direct Staff supervision. The cell phone (call or text) will be used by Staff to routinely check in with the student as well as convey important messages. If you do not agree to this mode of communication using the student cell phone, or if they do not have one, the student will be required to be with another student with cell contact consent or with a staff at all times. Do you consent for the student cell phone to be used for contact?

YES, I consent for my student's cellphone to be used for contact.

NO, My student will stay with another student with Cell Phone Use Consent or Trip Staff AT ALL TIMES.

Parent First Name *

Please enter the first name of the parent or guardian

Parent Last Name *

Parent Phone# *

This number will be used by the Music Director to contact the parent or guardian. ###-###-#### format

Confirmation *

By submitting this form, a pre-filled pdf document file will be sent to the first e-mail address entered. The PDF document must be printed, reviewed, signed, and returned to Mr. Gregoric by the due date. SUBMISSION OF THIS DIGITAL FORM IS NOT A SIGNATURE. FORMS ARE ONLY COMPLETE ONCE SIGNED AND SUBMITTED TO MR. G

I understand

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