Jog-A-Thon Permission Form printable pdf download

Jog-A-Thon Permission Form

Apperson Elementary School

Jog-A-Thon Pledge Form and Permission Slip

Student Name:_______________________________________ Phone Number: ___________________

Grade:_________________Teacher/Room #:________________________________________________

On Friday, Feb. 10th, 2017, I will be participating in the 3rd Annual Apperson Elementary School Jog-A-

Thon. I will have 20 minutes (15 minutes for K-1

) to complete as many laps as possible around the Jog-A-

Thon course set up at our school. The funds collected will go to the Apperson Elementary PTA and will

benefit all students. I hope you can help by sponsoring me. Any donation amount is appreciated.

Checks can be made out to Apperson PTA. Donations can also be made online with a credit card at

Contributions are tax deductible. Thank you for your generous support!

SPONSOR NAME

FLAT DONATION AMOUNT

PAYMENT TYPE

Cash – Check – Online

i.e. Generous Donor

$15.00

TOTALCOLLECTED $

Please return donations with this completed form on or before the Jog-A-Thon day – Feb.10

Apperson PTA is a 501(c)(3) non-profit organization. Tax ID: 95-6504118

Parents, the Apperson Jog-A-Thon will occur during your child’s regular school day. Please sign and return this form,

even if you do not collect donations, so that your child can participate with his/her class.

As the parent/guardian of the above mentioned student, I give my permission for my child to take part in the Feb. 10,

2017 Jog-A-Thon. I agree to hold harmless Apperson Elementary School, Apperson PTA and LAUSD.

Parent/Guardian Signature (required):__________________________________________ Date:_______________

PTA Use ONLY

Cash $__________ Checks $__________ Online $__________ TOTAL: $__________

Jog-A-Thon Permission Form