Permission Form/ Liability Waiver

Name of Event: Christmas Caroling

Destination: Alta Tierra Homes
Designated Chaperone: Ms. Ivy Lorraine S. Aguilar and Mr. Ivan Lawrence S. Aguilar
Dates/Times: The time will be approximately from 6pm to 8pm
December 17 (Tuesday)
December 18 (Wednesday)
December 19 (Thursday)
Meet- up point: Alta Tierra Integrated School

In consideration of the opportunity for my child to participate in the event. I

hereby consent the participation of my child ___________________________ in the
event described above. I further consent to the conditions stated above on
participation in this event. In the event of an emergency and I/we cannot be
contacted, I/we hereby authorize that emergency treatment may be
administered.
_____________________________________________________________________________________

Name of Participant: ____________________________________________________

Address: ____________________________________________________

Phone: ____________________________________________________

Emergency Contact Person: ____________________________________________________

Emergency Phone: ____________________________________________________

Parent/Guardian Signature: ___________________________________________

Date: ____________

Permission Form/ Liability Waiver

Name of Event: Christmas Caroling

Destination: Alta Tierra Homes
Designated Chaperone: Ms. Ivy Lorraine S. Aguilar and Mr. Ivan Lawrence S. Aguilar
Dates/Times: The time will be approximately from 6pm to 8pm
December 17 (Tuesday)
December 18 (Wednesday)
December 19 (Thursday)
Meet- up point: Alta Tierra Integrated School

In consideration of the opportunity for my child to participate in the event. I

hereby consent the participation of my child ___________________________ in the
event described above. I further consent to the conditions stated above on
participation in this event. In the event of an emergency and I/we cannot be
contacted, I/we hereby authorize that emergency treatment may be
administered.
_____________________________________________________________________________________

Name of Participant: ____________________________________________________

Address: ____________________________________________________

Phone: ____________________________________________________

Emergency Contact Person: ____________________________________________________

Emergency Phone: ____________________________________________________

Parent/Guardian Signature: ___________________________________________

Date: ____________