Tech Stuff '09 Permission Slip

Permission slip for Helena Tech Stuff ‘09 Student Name: _____________________ School: ________________
 Grade attending in 2009-2010 school year: _________


 Teacher attending conference with: ___________________
 Dates: Times:

Locations: Activities:

June 22-June 25, 2009 Monday 1:00-4:00 Tuesday 9:00-4:00 Wednesday 9:00-4:00 Thursday 9:00-1:30 Helena Middle School—1025 North Rodney Front Street Learning Center—815 Front Street Lunch provided Tuesday, Wednesday, and Thursday. Students will be walking between the two sites. Some sessions will include walking field trips.

Your child will be attending sessions at both locations. You will be informed of their drop-off and pick-up locations prior to the start of the conference. Please list any special medical and/or dietary needs your child has that we should be aware of. ___________________________
 ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
 Parent Name:

_______________________
 Parent Signature:
_______________________
 Please list contact information for at authorized to pick up your child: Name: ______________________ Phone Name: ______________________ Phone Name: ______________________ Phone

least two people that are number(s): _____________
 number(s): _____________ number(s): _____________