Central Bucks South 2017 Minithon Student Sign-Off Form

Central Bucks South 2017 MiniTHON Student Sign-Off Form

EACH team member must fill out this form. Team Captains should collect all forms and turn them in TOGETHER in a manila envelope. Tape or staple the Team Registration Form to the front of the envelope. This form should be returned to the miniTHON mailbox in the Main Hallway by 11/17/16.

Student Rules/ Acknowledgments

1. Pre-Registration is mandatory. To be completely registered, you must: a. Complete the Student Sign-Off Form AND Team Registration Form b. Submit your online registration fee of $20 to www.mypaymentsplus.com by Friday, 11/17 at 2:30 pm (NO CASH or CHECKS ACCEPTED) . c. Set up your INDIVIDUAL Donor Drive account

2. A minimum of $50 in donations is required to participate in miniTHON. All registered students will set up an online Donor Drive account during school from November 14-17th. Donor Drive will be our preferred way of collecting money however, checks may also be submitted. Checks should be made payable to CB South Student Activities Fund and must be submitted in an envelope with your name on it. You will have to have $50 donated by February 10th, 2017, or you will not be permitted to participate. CASH WILL NOT BE ACCEPTED AS YOUR REQUIRED DONATION.

3. Participants must stay within the designated areas during miniTHON. The miniTHON hours are from 4:30pm to 10:30pm on Friday, March 10th. Early departure is not permitted unless a note has been provided by your parent or guardian prior to the event.

4. School appropriate clothing is to be worn at all times during miniTHON (You will be given a miniTHON T-Shirt and you will be required to buy a new one if you cut, tie die or write on it in any way).

5. STUDENTS ARE PROHIBITED FROM “canning” at traffic stops, soliciting door to door in neighborhoods or businesses as per school board policy.

6. All school rules and regulations apply during miniTHON. The following activities are prohibited: Smoking, Vaping, Alcohol drinking, drugs or sexual misconduct/harassment. If any of these behaviors are exhibited, police, chaperones and/or school officials will contact you parent/guardian immediately and school board policy will be implemented. STUDENT SIGN-OFF FORM:

*STUDENT AGREEMENT*

I, ______, understand the rules/regulations for miniTHON & agree to abide by them.

Student Signature: ______Date: ______

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*PARENT/GUARDIAN PERMISSION*

I ______grant permission for my child, ______, to participate in the 6 hour miniTHON event on Friday, March 10th, 2017 at Central Bucks High School South. I understand that my child cannot leave the premises at any time without a parent permission slip. I also understand that any student who is to receive medication should list their conditions below. I understand that my son/ daughter must raise a minimum of $50 by February 10th, 2017.

NOTE: There is the possibility that strobe lights will be used during miniTHON. Please be aware of this and alert us of any health conditions that could be affected by this below.

Health Conditions/ Medicine needed:

______

*NEWS PUBLICATION CONSENT*

I give permission for my son/daughter to be used in news publications for miniTHON and in school media.

______Yes or ______No

Parent/Guardian Signature:______Date:______

Contact Number Night of miniTHON (in case of emergency):______

Alternate Emergency Contact Number: ______