Parent Permission Form printable pdf download

Student Name_______________________________________ Student ID #_____________________________

Leave blank, CSAP office use only

GHS Community Service Awards Program

PARENT PERMISSION FORM

All students must complete and submit this form BEFORE beginning their community service.

Students who participate in the GHS Community Service Awards Program are encouraged to volunteer their time to help others by

performing community service. We believe this program enhances skills, builds character and fosters personal growth. Participation of all

students is both welcomed and encouraged.

PARENT SECTION

Parent’s Name_________________________________

By giving my son/daughter permission to participate in the GHS Community Service Awards Program, I understand and agree that:

• The program usually requires students to be off campus working with outside agencies.

• Transportation to and from the agency is the responsibility of the student.

• GHS is not liable for accidents during community service activities or for accidents in transit to and from those activities.

• GHS is not liable for any injuries or misfortunes that may result from a student’s participation in any community service activity.

• School personnel will not be on-site to supervise students.

I am the legal guardian for the student named below, and he/she has my permission to participate in the GHS Community Service Awards Program.

Signature of Parent/Guardian_______________________________________________________Date_____________________________________

Printed Name of Parent/Guardian___________________________________________________ Phone #___________________________________

STUDENT SECTION

As a participant in the GHS Community Service Awards Program, I realize that my behavior in the community is a reflection of my school.

I promise to observe GHS rules of conduct and to behave in a manner that will make my school proud to send me into the community as a

representative of GHS.

Student’s Signature _______________________________Date ______________Email _________________________________________________

Printed Name of Student ____________________________________Student ID # _______________Grade _____Phone ______________________

This form must be on file at your Grade Level Center before you begin your community service, or as soon as possible thereafter.

Parent Permission Form.doc (rev. 6-2015)

Parent Permission Form