Permissions & Agreements 24-25

Permissions & Agreements

Please complete the following permission slip items and acknowledge the statements of below. PLEASE COMPLETE ONE FORM PER CHILD CURRENTLY ENROLLED AT FPDS.
Student
Student's Name*

First NameLast Name
Grade/Homeroom*
T-Shirt Size*

PERMISSIONS
I give permission for my child to be photographed/videoed for school marketing, social media and website use.*

YesNo
I give permission for my child to participate in Field Trips and Field Day at the end of the school year.*

YesNo
I give permission for my child to participate in any sports or extracurricular activities in which we choose to participate in.*

YesNo

MEDICAL TREATMENT

This section pertains to a medical emergency and a child's parents or emergency contacts are not available or a life-threatening situation occurs in which immediate medical assistance is needed.Please ensure all medical conditions, medical information, insurance and emergency contacts are up-to-date in your ParentsWeb/FACTS account.In order for the school office to dispense any kind of medicine, the following consent form must be completed and submitted directly to the office with the medication. (Please see school office for medical form.)
I give permission for my child to be medically treated or transported to the hospital in the event of a medical or life-threatening emergency.*

YesNo
Please list any allergies & how severe. If none, reply n/a.*
Preferred Hospital*
Primary Doctor's Phone #*
Primary Doctor's Name*

STATEMENT OF UNDERSTANDING

Please indicate that you understand the following items.
I understand it is my responsibility to ensure our contact information is accurate and up-to-date in FACTS.*

I agree
I understand my FACTS account will be charged for lost or damaged library books.*

I agree
In order to minimize disruptions to the last period of the day, I understand there are no check-outs between 11:30am and 12:15pm for K3, K4 and kindergarten, and no check-outs after 2:15 p.m. for K3-6th grade students, unless it is an emergency. I will notify grandparents and other authorized persons who pick my child up of this policy.*

I agree

SIGNATURE
Parent/Guardian's Name*

First NameLast Name
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Signature*

Clear
Use your mouse (desktop/laptop) or finger (mobile device) to sign.
Should be Empty:

Permissions & Agreements