ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
2
3
4
5
6
Program Name: _______________________________________________
7
Program Start Date: ____________ Program End Date: ____________
Participant Sign In and Out Daily Log Sheet
8
Program Start Time: ____________ Program End Time: ____________
9
Program Supervisor: _____________________________
10
Instructions: all headers in grey are to be filled out by the parent or legal guardian Dropping off or Picking up the youth participant. This information should NOT be filled out in advance and is to be done daily per Program.
11
Participant Last NameParticipant First NameM.IAgeGenderPrinted Name of Parent or Legal Guardian Dropping off ParticipantContact/Reachable Phone Number with area codeSign In TimeSignature of Parent or Legal Guardian Dropping off ParticipantCSUMB Staff IntitialsPrinted Name of Parent or Legal Guardian Picking up ParticipantSign out TimeSignature of Parent or Legal Guardian Picking up ParticipantCSUMB Staff Signature
12
1
13
2
14
3
15
4
16
5
17
6
18
7
19
8
20
9
21
10
22
11
23
12
24
13
25
14
26
15
27
16
28
17
29
18
30
19
31
20
32
21
33
22
34
23
35
24
36
25
37
26
38
27
39
28
40
29
41
30
42
31
43
32
44
33
45
34
46
35
47
36
48
37
49
38
50
39
51
40
52
41
53
42
54
43
55
44
56
45
57
46
58
47
59
48
60
49
61
50
62
51
63
52
64
53
65
54
66
55
67
56
68
57
69
58
70
59
71
60
72
61
73
62
74
63
75
64
76
65
77
66
78
67
79
68
80
69
81
70
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100