Wexliem for the Youth Resource Fair

*** In order for your child to participate this form must be signed and submitted on or before the morning of the field trip. ***
Students Full Name:
Parent Guardian Name
Phone Number
Please enter a valid phone number.
Address
City, State, Zip Code
Teacher's Name:
Grade:
I have carefully read this Release of Liability, and I give permission for my child to attend this field trip.
Emergency Contact Name:
Emergency Contact Phone Number:
I give permission for my child to attend this field trip.

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PARENTGUARDIAN SIGNATURE

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