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Salem Lutheran School

3rd Grade Reading Club

Permission Slip

I _________________________________ give my child _____________________

(your name) (child’s name)

permission to participate in the Salem Lutheran School 3rd Grade Reading Club.

Please initial below:

_____ I understand that I am releasing my child to the care of Katie Madriles and

Rebecca Mauzey on the scheduled Reading Club Fridays (dates will be told

ahead of time)

_____ I understand that my child will be reading Charlotte’s Web.

_____ I understand that I am responsible for picking up my child from Salem

Lutheran School at 4:00 PM at Big Circle on Reading Club Fridays.

My phone number is: ______________________________________

_____ I give permission to Katie Madriles and Rebecca Mauzey to call me or take

my child to school age care if I am not at Big Circle at 4:00 PM.

Food allergies my child has: _______________________

(snacks will be provided, so if there is an allergy, Katie &

Rebecca need to know)