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technodogs:forms:permission_slip [2022/10/01 16:12] worthingtechnodogs:forms:permission_slip [2022/10/01 17:00] (current) – external edit 127.0.0.1
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 <html><font size=-2 color=blue>(right click on page and choose print)</font></html>\\ <html><font size=-2 color=blue>(right click on page and choose print)</font></html>\\
-{{ :technodogs:forms:bas-logo-final-100-cropped.jpg?direct&100|}}+{{ :technodogs:forms:bas-logo-final-100-cropped.jpg?direct&150|}}
 <html><font size=+1>Parent/Guardian</font></html> \\ <html><font size=+1>Parent/Guardian</font></html> \\
 <html><font size=+1>Field Trip/Activity</font></html> \\ <html><font size=+1>Field Trip/Activity</font></html> \\
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   I hereby give may consent for  __________________________________________________________________   I hereby give may consent for  __________________________________________________________________
                                                             Student Name                                                             Student Name
-to accompany their teammates on a trip to participate in \\ +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** \\ +(put name, location, date of competition here)  
-and understand that they will be transported by a Private Vehicle. +and understand that they will be transported by a Private Vehicle. \\ \\ 
-=== Authorization and Release for a Passenger in a 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. I give my permission for my child to be a passenger in a vehicle driven by a Coach or School Approved Mentor.
          
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 **Emergency Information** \\ **Emergency Information** \\
-   +
   ______________________________   ______________________________   ______________________________   ______________________________   ______________________________   ______________________________
-            Home Phone                        Cell Phone                       Work Phone +           Home Phone                        Cell Phone                       Work Phone 
-    +     
   ________________________________________   _____________________________________________________   ________________________________________   _____________________________________________________
         Name of Insurance Carrier                   Family Physician Name and Phone Number         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): Medication that **must accompany the child** and information that you wish to share (ie. allerigies, medications, medical conditions, etc):
-        +
    ______________________________________________________________________________________________________    ______________________________________________________________________________________________________
  
technodogs/forms/permission_slip.1664640768.txt.gz · Last modified: 2022/10/01 17:00 (external edit)

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