PTO Permission Slip - 2017 Firehawk Dash Experiences!
Child's Name *
Your answer
Grade *
Your answer
Teacher *
Your answer
Parent Name *
Your answer
Parent Phone Number *
Your answer
Parent Email *
Your answer
Emergency Contact *
Your answer
Emergency Phone Number *
Your answer
Does your child require any medication while participating? *
Does your child currently have an individualized plan such as an IEP, 504, or health care plan? *
Please List Any Allergies *
Your answer
Photo Release: I give my permission to have my child photographed. *
Transportation Home AFTER Activity: *
Please initial and date below *
This form acknowledges that the child listed above has your permission to take part in the listed activity. By initialing and dating the form below, you acknowledge that participation in this activity involves some risk of injury or death, and acknowledge that the participant is physically capable of performing this activity. Furthermore, you acknowledge that you release and hold harmless the St. Vrain Valley School District and its personnel from any liability for any injury or death arising from this participation or activity.
Your answer
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This form was created inside of Central Elementary PTO.