Student Registration and Permission Slip
This is a permission and consent form for the below named student to attend "Vape Escape: Canvas and Conversation" event at the Bryant Neighborhood Center (1619 6th Ave., Tacoma, WA  98405) on Friday, November 22, 2024 from 3:30-5:30.
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Student Name *
Preferred Pronouns *
Parent / Guardian
First and Last Name 
 *
Relationship *
Phone Number  *
Email *
Emergency Contact  *
Relationship *
Mobile Phone *
In the event of an emergency involving the student listed above, I understand that every effort will be made to contact a guardian or emergency contact listed above. If no one can be reached in a timely manner, I give permission for the Bryant Neighborhood Center staff to seek, authorize, and consent to such medical care for the student as deemed necessary or appropriate by medical professionals. I give permission to those administering emergency treatment to do so, using measures deemed necessary. I absolve the Bryant Neighborhood Center and its staff from liability in acting on my behalf in this regard. *

The BNC requests your permission to photograph and/or create videos during some of our TAP activities. These images may be used to create video montages, to celebrate TAP in our newsletters, on social media, websites, and other publications.

I give the Bryant Neighborhood Center permission to use photographs and/or video recordings internally and externally to promote TAP and the BNC/Bryant Montessori School partnership.

 *

For those coming from Bryant Montessori:

I hereby grant the above named student permission to attend the Vape Escape Canvas and Conversation event on Friday, November 15, at the Bryant Neighborhood Center (BNC), 1619 6th Avenue, Tacoma, WA, from 3:30 p.m. to 5:30 p.m. Registered students will meet at the front office and will be accompanied by BNC adult staff and volunteers to walk from Bryant Montessori to the BNC at the end of the school day. 

I understand that I will need to pick up my student at 5:30 p.m. at the Bryant Neighborhood Center.

 *
I understand and agree that by typing my name below I am providing a binding electronic signature verifying the above information. *
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Dieses Formular wurde bei Trinity Presbyterian erstellt.

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