After School Study Consent Form - This must be filled out each time they attend:
Has permission to attend after school study on (date):
Please select one:
*Note, if they will be riding the activity bus, they will be responsible for signing themselves up on the list!
If walking - time leaving and destination:
If picked up - time and by whom:
Contact phone number between 3:15 - 5:20 in the event we need to contact you:
Please initial here to give your consent:
Children can be picked up earlier in room 121/Wendy Walker's room.
Thank you for your cooperation. Your child's safety is our primary concern.
The Three Lakes School District Elementary After School Program Staff.
* Enter Your Email Address: