Arizona Science Olympiad Program

Arizona Science Olympiad – Div B 2014 - 2015 Parental Permission Form

Parents: Please complete and return to your child’s Science Olympiad Coach

(Student’s Name) (Home Address)

(Home Phone Number) (Cell Phone Number)

My child has my permission to stay after school for Science Olympiad Practices as scheduled by the Science Olympiad Coach. My child has my permission to participate in and/or be transported to the following Science Olympiad Events. Northern Arizona Invitational @ Glassford Hill Middle School at 6901 Panther Path, Prescott Valley, AZ 86314 on October 25, 2014

Eduprize Invitational at 4567 W Roberts Road, Queen Creek, AZ 85142 on November 1, 2014

Our Mother of Sorrows Invitational at 1800 S Kolb Road, Tucson, AZ 85710 on November 15, 2014

Surprise Invitational at 12907 W Greenway Road, El Mirage, AZ 85335 on November 22, 2014

Casa Grande Invitational at 330 W McMurray, Casa Grande, AZ 85222 on December 13, 2014

Paragon Invitational at 5580 W Chandler Blvd Chandler, AZ 85226 on January 24, 2015

Southern Regional @ Desert Sky Middle School at 9850 E Rankin Loop Tucson, AZ 85757 on February 14, 2015

North Central Regional @ Rainbow Valley Elementary School at 19716 W Narramore Rd, Buckeye, AZ 85326 on February 28, 2015

Arizona State Tournament @ Central Arizona College – Signal Peak Campus at 8470 N Overfield Road, Coolidge, AZ 85128 on April 11, 2014

I understand that the Arizona Science Olympiad program and/or personnel do not accept liability for the students in the above noted events.

If emergency service involving medical action or treatment is required for my child and neither parent nor family physician can be contacted for consent, I hereby grant permission for rendering of such emergency medical service.

My son/daughter shall be responsible for avoiding food to which he/she is allergic and/or which may endanger safety. I give permission for my child to self-administer any pre-approved normally required medicine.

(Doctor’s Name) (Doctor’s Phone Number)

(Insurance Carrier) (Policy Number)

(Parent or Guardian’s Signature) (Date) Arizona Science Olympiad – Div B 2014 - 2015 Parental Permission Form