After School Permission Form
Please complete this form to provide permission for your child to participate in after school activities or arrangements.
Student's Full Name
*
First Name
Last Name
Grade/Class
*
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Please specify the after school activity or arrangement for which you are granting permission.
*
Date(s) of Activity or Arrangement
*
-
Month
-
Day
Year
Date
Authorized Person for Pick-Up (if applicable)
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Notes or Instructions (optional)
Parent/Guardian Signature
*
Submit Permission
Submit Permission
Should be Empty: