TREVOR-WILMOT CONSOLIDATED GRADE SCHOOL DISTRICT
TREVOR GRADE SCHOOL
26325 WILMOT ROAD
TREVOR, WI 53179-9701

Parent permission for Extracurricular Activities


I give my child, ________________________________, permission

to participate in the following activity ______________________________________ for Trevor Grade School.

I understand that my child must have a statement of physical fitness from a physician for him/her to participate in athletics for the current school year per the “Eligibility” requirements of Policy 370.

I understand that if my child is injured in this activity, the coach will contact me and he/she will call the Rescue Squad to provide emergency first aid if deemed appropriate by the coach.

___________________________________________ _____________________
Parent/Guardian Signature                   Date

I have read the Extracurricular Activities Rules and Regulations for Student Participation and agree to adhere to these requirements regarding student participation in the activity.

___________________________________________ ______________________
Parent/Guardian Signature                   Date

___________________________________________ ______________________
Student Signature                           Date

*A $50 deposit for girls’ and boys’ basketball, pom-pom and cheerleading uniforms will be required and will be refunded when the uniform is returned in proper shape.

Policy 370