ARML 2019 PERMISSION SLIP

I hereby acknowledge that my son / daughter __________________________________ will participate in a trip to the American Regions Mathematics League meet at Penn State in State College, PA on May 31 – June 1, 2019. I will see that my child gets to the Bridgewater Municipal Lot by 7:45 A.M. on May 31. I will pick up my child at the same place promptly on return of the bus, at about 9:30 p.m. on June 1.  I understand that students will be housed in dormitories, chaperoned by faculty members with strict rules and curfew to be precisely followed.

On behalf of myself, my heirs, executors, administrators and assigns, I hereby waive and release any and all rights and claims for damages I may have against you, the school district, Penn State University as well as any other persons connected with the American Regions Math League and its competition, their heirs, executors, administrators, successors and assigns for any and all injuries which my child may suffer while taking part in the American Regions Math League and/or competition or as a result thereof.

I will be able to be reached by telephone at ________________________ in the event of an emergency. I grant authority for chaperone Amro Mosaad to act in my stead until I can be reached.

Signed ____________________________________ Date _______________

Special dietary requirements that my child has: __________________________________________________________________________________________________________________________________________________

Medications that my child will bring on the trip: ____________________________________________________

(Chaperones cannot administer medication on the ARML trip.  If your child has a medical condition that requires medication, your doctor must provide a note indicating that the child has permission to administer the medication to him/herself. Please attach the note to the permission slip. All medication, prescription or non-prescription, must be in the original labeled container. Only the number of doses required for the ARML trip should be included.)

Please print this form, fill it out, and bring it to one of the ARML practices.