I give permission for my child to attend the February Fun Fest after school on February 24, 2012 from 2:00 p.m. to 4:30 p.m. I am responsible for my child’s transportation home promptly at 4:30 p.m.

Child’s Name______________________________________________

Child’s Teacher_____________________________________________

Name of Parent/Guardian_____________________________________

Signature of Parent/Guardian__________________________________

I choose Package  #_____ for my child with $_________ check or cash enclosed (please circle one)

Hot dog or pizza (please circle one)                Water or soda (please circle one)

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