Parental Consent for Club Participation
Review the club’s categorization statement and provide your consent, signature, and date.
Student Name
*
First Name
Last Name
School
*
Please Select
Antimony Elementary
Boulder Elementary
Bryce Valley Elementary
Bryce Valley High
Escalante Elementary
Escalante High
Panguitch Elementary
Panguitch Middle
Panguitch High
Garfield Online
Club Name
*
I have received the club's categorization statement as provided in its application.
Do you give permission for your student to participate in this club?
*
I give permission for my student to participate in this club
If the club is sponsored by a different District school than the one the student attends, specific parental permission for membership at that school is also required.
This club is at another District school and I specifically permit membership there
This club is at another District school and I specifically permit membership there
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
Should be Empty: