Personal Data Form (Page 2 of 2) in pdf

Personal Data Form Page 2

PERMISSION FORM FOR FIELD TRIPS

______ I give permission for my child to go on scheduled fieldtrips with his or her class.

Notice will be given prior to the fieldtrip.

PUBLICATION RELEASE

______ I give permission for my child to be a part of any public relations event (such as a picture

in the newspaper) involving Community Preschool while he or she is in attendance.

______ I give permission for my child’s photo or artwork to be posted to the Community Preschool

Facebook page or website.

INFORMATION RELEASE

______ I give permission for my child’s name and family contact information to be listed in a

class list.

Information I would like to be shared:

Parent(s) Names: ________________________________________________

Address:________________________________________________________

Phone: (_______)_________________________

______ If a referral is needed, I give permission for Community Preschool to discuss my child with

District 206/ECSE staff.

______ I give Community Preschool permission to share information about the preschool

experience of my child with his or her kindergarten teacher, to help the teacher have a better

understanding of my child in a school environment.

I have carefully read and understand the above information. I have indicated my consent and

authorization where applicable.

_____________________________________________________________________________

Signature of parent or guardian

Date

Personal Data Form Page 2