Consent Form Return
Parent
Consent Form
This form is to be used by students who are involved
in a school-related activity outside of school during the school day.
It is to be completed and returned by the date noted below.
NAME OF
STUDENT_______________________________________________________
INSTRUCTOR IN CHARGE T.
Thierfelder
.
TYPE OF ACTIVITY MATH
MEET AT
DATE OF ACTIVITY
TIME OF DEPARTURE
THE STUDENT HAS PERMISSION TO RIDE WITH
SCHOOL BUS
.
THE STUDENT HAS PERMISSION TO CARRY THE FOLLOWING
PASSENGERS. (IF NONE, WRITE NONE)
NONE
.
____________________________
We, the undersigned, parents of
____________________________________,
a minor, do hereby give our consent to the
participation of our son/daughter in Wisconsin Lutheran High School sponsored
events, either as an active participant or as a spectator, and hereby release
and forever discharge Wisconsin Lutheran High School Conference from any and all
liability for injuries sustained by son/daughter while being transported to or
from such event(s) in a school bus, our automobile or in any other automobile
with our consent and authority.
DATED _________________________________
_________________________________
(Father’s signature)
_________________________________
(Mother’s signature)
Return this form by