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Field Trip/Activity
Permission Form

Name of School/Org: Brighton High School Robotics Team

I hereby give may consent for  __________________________________________________________________
                                                          Student Name

to accompany their teammates on a trip to participate in Bloomfield Girls Robotics Competition located at Bloomfield Hills High School in the city of Bloomfield Hills on the dates of Oct 14, Oct 15 and understand that they will be transported by a Private Vehicle.

Authorization and Release for a Passenger in a Vehicle
I give my permission for my child to be a passenger in a vehicle driven by a Coach or School Approved Mentor.

_____________________________________________________________             __________________
           Parent or Legal Guardian Signature                                    Date

Emergency Information

______________________________   ______________________________   ______________________________
         Home Phone                        Cell Phone                       Work Phone
________________________________________   _____________________________________________________
      Name of Insurance Carrier                   Family Physician Name and Phone Number

Medication that must accompany the child and information that you wish to share (ie. allerigies, medications, medical conditions, etc):


Authorization and Release for Medical Care
I authorize Brighton Area Schools, its employees, designees, or sponsors in attendance at any Brighton Area Schools or Robotics Team event to secure, select and consent to necessary medical attention for may child resulting from injury, illness or accident requiring medical care while I am not in attendance.
I release the Brighton Area Schools and such person(s) from any liability for the selection in securing of a medical provider.

_____________________________________________________________             __________________
           Parent or Legal Guardian Signature                                    Date
technodogs/forms/girls_comp_2022_ps.txt · Last modified: 2022/10/22 17:17 by worthing

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