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--- technodogs:forms:permission_slip [2022/10/01 15:35] – worthing
+++ technodogs:forms:permission_slip [2022/10/01 17:00] (current) – external edit 127.0.0.1
@@ Line 1: / Line 1: @@
-{{ :technodogs:forms:bas-logo-final-100-cropped.jpg?direct&200|}}
+<html><font size=-2 color=blue>(right click on page and choose print)</font></html>\\
-<html><font size=+2>Parent/Guardian</font></html> \\
+{{ :technodogs:forms:bas-logo-final-100-cropped.jpg?direct&150|}}
-<html><font size=+2>Field Trip/Activity</font></html> \\
+<html><font size=+1>Parent/Guardian</font></html> \\
-<html><font size=+2>Permission Form</font></html> \\
+<html><font size=+1>Field Trip/Activity</font></html> \\
+<html><font size=+1>Permission Form</font></html> \\
-----
+<html><font>Name of School/Org: <strong>Brighton High School Robotics Team </strong></font></html> \\
+  I hereby give may consent for  __________________________________________________________________
-<html><font size=+1>Name of School: <strong>Brighton High School</strong></font></html> \\
+                                                            Student Name
-<html><font size=+1>Name of Organization: <strong>Robotics Team - FRC 3707 - The TechnoDogs</strong></font></html> \\
+to accompany their teammates on a trip to participate in
-\\
+(put name, location, date of competition here)
-I hereby give may consent for
+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
-                        Student Name
-to accompany their teammates on a trip to participate in \\
+**Emergency Information** \\
-**Bloomfield Girls Robotics Competition** located at **Bloomfield Hills High School** in the city of **Bloomfield Hills**	on the dates of **Oct 145, 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.
+           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
-               Parent/Guardian Signature                                           Date