<p> Mill Creek High School After School Hours Activity Form</p><p>PART ONE: To Be Completed By Sponsor</p><p>ACTIVITY : Greater Atlanta Math Tournaments</p><p>LOCATION : North Gwinnett High (Oct-Feb); Norcross (March)</p><p>DATE : Oct 19; Nov 16, Jan 11, Feb 22, Mar 21</p><p>TEACHER IN CHARGE: Teresa Hunsucker</p><p>PART TWO: To Be Completed By Parent/Guardian.</p><p>I give my son/daughter (student)______permission to participate in this school activity. YES NO</p><p>Describe below any medical conditions or currently prescribed medications that the sponsoring teacherThis should form be made should aware be ofused for forthis schoolactivity. sponsored Please list anyactivities emergency taking medication place that needs to accompany afterstudent. regular school hours or on weekends. ______</p><p>If medication needs to accompany student, an Administration of Medication Request Form must be filled out and given with the needed medicine in an original container to the teacher, who will be responsible for it.</p><p>I agree to assume responsibility for any unforeseen accident that might occur during travel or participation in this activity. I also authorize any emergency medical treatment that may-be necessary. I further recognize that students on school trips must adhere to the same code of behaviors as if they were on the school campus and are to follow the instructions of teachers, sponsors, bus drivers, chaperones, etc.</p><p>NAME OF PARENT/GUARDIAN(PRINT)______</p><p>SIGNATURE OF PARENT/GUARDIAN______</p><p>DATE______</p><p>HOME PHONE #______WORK PHONE #______</p><p>EMERGENCY CONTACT (IF NECESSARY)______</p><p>EMERGENCY CONTACT PHONE # ______</p>