PCS Permission Slip 21-22

PARTICIPATING IN THE THEATRE PROGRAM

Thank you for taking the time to visit our site and fill out this form.

**Please note that if you participate in ANY other after-school activity you will need some of these forms so it would be advisable to make a copy of these forms.***

HERE IS WHAT YOU NEED

The following forms are online and need to be filled out. Remember there are THREE separate forms that must be submitted.

1. Field Trip/Activities Permission Form

Just to be safe and to make sure we are always covered so we require both the PCS form AND the athletic permission slip to be filled out.

2. High School Activities Participation Form

Yes, this is another permission slip, but it covers a few different items. This is necessary in case you get hurt or need medical attention for any reason.
Keep in mind this is primarily meant for athletics so don't get scared when you read it.
If you also play a sport, you've likely filled this out and turned it into your coach. Please fill this out online for us so we have it for our records. Thank you.

3. Media Release

We will publicize in any possible way that we can. Often times that means contacting a TV or radio station, a newspaper, or putting something online. The media release allows us your permission to use your son or daughter when those times come up.

4. Student Insurance

This is NOT included in this packet as it must be completed ONLINE
Go to the school insurance page on this site or to pcsb.org/studentaccidentinsurance
You can purchase whichever policy you’d like, but the least expensive one is fine.
Once it’s purchased, you’ll get an email confirmation. Save that confirmation a PDF or JPEG and upload it on the site.

Again, without these forms, a student CANNOT stay after school for ANY reason with ANY club or sport

By filling this form out you are hereby granting the student named below permission to participate in a field trip to various theatre-related events, festivals, or competitions during the 2021-2022 school year. You also understand that authorized emergency stops may be made as necessary. Dates and times for departures and arrivals will vary depending on the event. Proper notification will be given before each event.

You understand that students may travel by school bus, commercial carrier bus, or by a private passenger vehicle. Also, a district employee, volunteer driver, or student driver may be driving your student to and from the event.

Student Name *

1) I authorize school representatives to obtain medical treatment for my child, which includes required emergency transportation, in case of serious illness or injury and agree to pay for such treatment.

2) I understand that the trained school employee who usually dispenses medications may or may not be present during this trip. Medications will be dispensed by a responsible staff member.

3) I have documented below all precautions / instructions regarding my child’s medication. I have noted any special health-related conditions or allergies regarding my child.

4) All provisions of the student code of conduct apply to field trips and activities. To ensure student safety and compliance with the student code, I agree that my child’s luggage, belongings, and rooms (where applicable) may be randomly searched for contraband.

If the Field Trip is to a District or non-District site where students will have the opportunity to touch and hold animals, please complete the following:

Special Health Related Conditions

Please list any health related conditions or allergies regarding your child

Your child will have the opportunity to touch and hold captive animals during this field trip. Please check one space below to indicate your approval or denial *

YES, my child may touch and hold the animals. NO, my child may NOT touch and hold the animals.

* From time to time students may be allowed to drive other students to and from field trips or activities on a case-by-case basis, and only with administrative approval. *

I agree I do not agree (check one) to allow my child to ride with another student.

Signature (use your finger or mouse) *

Clear

Parent/Guardian Phone (Home)

Parent/Guardian Phone (Work)

Parent/Guardian Phone (Cell) *

Alternate Emergency Contact *

Alternate Emergency Contact Phone (Home)

Alternate Emergency Contact Phone (Work)

Alternate Emergency Contact Phone (Cell) *

Today's Date *

Date

To submit the form

Click the "Submit" button below
Remember it is NOT turned in until you hit the submit button!!
You MUST click the submit button! Once you hit submit you're done! No need to turn in a hard.
Don't forget though, you need to submit all THREE forms :)

View the completed PDF

Click the "Preview PDF" button below
Click Submit then on the next page click the "download completed PDF" button.
It is HIGHLY suggested that you download a copy of the completed PDF for your records.

PCS Form 3-2718 (Rev. 2/20) Review Date 2/21

Pinellas County Schools