Student Permission Slip Template - Free Download
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Student Permission Slip Template
Student Permission Slip Template
Permission Slip
The Robinswood Middle School Chorus is planning an educational field trip to Edgewater High School
to perform in the Orange County’s Music Performance Assessment on Saturday, April 5, 2003. We will leave
Robinswood Middle School at 7:30 am and will return to school at 1:30 pm. This is a graded assignment;
please complete the official permission slip below. Your child will not be allowed to go on the trip if the
permission slip is not turned in and/or your child does not have at least a 2.0 Grade Point Average. If your child
does not attend the trip for any reason, he/she will have to complete a 3-page research paper. The topic will be
determined at a later date. The deadline for turning in the permission slip is Friday, March 28, 2003. If you
would like to chaperone the trip, please contact me, Erica Fricke, as soon as possible at school (407) 296-5140
x230. If we do not have enough chaperones, we cannot go to the festival.
All students need to wear their royal blue Robinswood Middle School Chorus Uniform shirt, plain black
pants, black socks and black shoes (not sneakers). All students are to leave all necklaces at home. No
necklaces! Ladies, your hair needs to be half up or all the way up, earrings smaller than a nickel and no glitter.
If you still need to purchase a uniform shirt, I can put the order in no later than April 25
. The shirts are $18.00
for adult sizes and $17.00 for a child large.
We will be eating at Edgewater High School. Make sure you bring enough money to buy lunch. Do not
bring book bags. There is no reason for you to bring CD players, game boys, extra clothes, etc.
Performance Times:
Women’s Chorus: 9:30 am
Men’s Chorus: 11:15 am
Parents, relatives and friends are encouraged to watch the performance even if they are not chaperoning.
****************************************Detach Here***************************************
Parental Consent / Insurance Participation Form
Deadline to turn in permission slip: Friday, March 28, 2003
To: Edgewater High School
Re: Music Performance Assessment, Saturday, April 5, 2003
Student Name:_________________________________________________________ Grade:______________
I hereby give my consent for the above-mentioned student to engage in this school-approved activity. I
also give my consent for my child/student to be transported in connection with this activity. I further give my
permission for the appropriate school staff or their designees to render emergency treatment or authorize
medical treatment by a hospital and/or doctor associated with an injury. I agree to hold the School Board
employees harmless in the administration of such emergency assistance. I will abide by Orange County Student
Code of Conduct, Robinswood Middle School rules and regulations as well as guidelines set up by Ms. Fricke.
Insurance Company_________________________________________ Policy Number___________________
___________________________ _________ ________________________
Parent / Guardian Signature Date Home Phone Number
___________________________ _________ ________________________
Student’s Signature Date Work Phone Number
Student Permission Slip Template Previous Page
Student Permission Slip Template