Lafayette SWAT Membership Form 21-22

Lafayette SWAT Membership Form
Student's Full Name

First NameLast Name
How Would You Like To Be Contacted
Text Number
Email Address
I hereby grant permission for my son/daughter to participate in the Students Working Against Tobacco (SWAT) program of Lafayette County for the period of time from July 1, 2021 through June 30, 2022. I give my consent for participation and acknowledge that photos/video footage may be captured as part of SWAT activities and I give my permission for photos/footage of my son/daughter to be used for programatic purposes.
Parent or Guardian Signature

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