Multi Permission Form
Multi Permission Form
Please complete the Multi Permission Form and submit.
1
Parent/Student Information
>
2
School Year
Parent/Guardian Information
Name:
Name:
*
First
Last
Address:
Address:
*
Street Address
Address Line 2
City
State / Province / Region
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal / Zip Code
Country
United States
Phone:
Phone:
*
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###
-
###
####
Email:
The Photo Consent, Field Trip Permission, Computer Usage, and No Bully Pledge information applies to all the child(ren) listed below.
Please enter your Child(ren)'s Names here:
Photo Consent
Zion Lutheran School would like your consent to use your child's or children's photograph in publications, or on our website.
I will allow Zion Lutheran School to use photographs of my child(ren), that are listed above, in newsletters, promotional brochures and on the school's website. I understand that my child(ren) will not be identified by name.
*
Yes
No
Field Trip Permission
I grant permission for my child(ren) to participate in field trips sponsored by Zion Lutheran School, which will take my child away from the school premises. I understand that this approval is for the school year and I will be notified in writing by my child's teacher prior to each field trip.
*
Yes
No
Computer Usage - Grades 3 - 8
I have read and reviewed the Student/Parent Computer Use Agreement included in our Enrollment Packet. I will abide by the rules and policies as set forth in the agreement.
*
Yes
No
No Bully Pledge
I agree to do our part in preventing bullying at Zion Lutheran School. We have read and reviewed the No Bullying Policies and Procedures that had been provided to us.
*
Yes
No
Parent/Guardian Signature:
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Date of Signature:
Date of Signature:
*
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