BROTHER TO BROTHER PERMISSION SLIP

Parents/Guardians: Please note that our insurance policy, which we are required to carry, covers your student(s) during all activities at 11 Pine Sreet, Montclair, NJ, and during any offsite events. However, in order for your student to be covered, and our organization to be protected, they must have a current application on file. One is required at the beginning of each school year.

If you have not done so yet, please go to this link to complete an application now: BROTHER TO BROTHER / LITTLE BROTHER TO BROTHER MENTORING APPLICATION FORM (jotform.com) before completing this permission slip.

We do not want to turn any student away from participating in Brother to Brother, however, we must adhere to our insurance guidelines.

Thank you for your understanding.

NOTE: Please fill out and return this form by hitting SUBMIT button below. Your child will not be allowed to attend this event without returning this completed form, and have an application on file.

Your child will be attending:

Bowling at Bowlero Belleville, 679 Washington Avenue, Belleville, NJ 07109.

Date

MonthDayYear

We are asking parents to drop their child(ren) off at Bowlero Bowling. Please plan to arrive at the bowling place by 1:30 pm.

If your child needs a ride, please contact Joe Davis to let him know and to make arrangements.

We are going RAIN or SHINE!

Parents are requested to pick up their child from Bowlero Bowling no later than 4:15 pm.

If Brother to Brother transported your child to Bowlero, we ask that you adher to those arrangements.

COST: FREE. Shoes and Pizza included.

TRANSPORTATION: By parents. If your child needs a ride to and from Bowling, please contact Joe Davis.

Should you have any questions about this field trip please contact Executive Director, Joe Davis, at 201 306 1518.

NOTE: PLEASE COMPLETE A PERMISSION SLIP FOR EACH CHILD WHEN MULTIPLE CHILDREN ARE ATTENDING.

This is to certify that I give permission for my child

Child's Name*

First NameLast Name

To attend the field trip noted above.

In case of an emergency, I give permission for my child to receive medical treatment. In case of such an emergency, please contact:

Emergency Contact Person*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

Parent / Guardian Name*

First NameLast Name

Parent / Guardian Phone Number*

Area CodePhone Number

Parent / Guardian Signature (please type)*

Parent's Email*

example@example.com

BROTHER TO BROTHER MENTORING PROGRAM