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WAPELLO MIDDLE SCHOOL/HIGH SCHOOL

DECLINE TO ALLOW STUDENT

PERMISSION FORM

STUDENT NAME ________________________________________________________________

                             PLEASE PRINT

GRADE LEVEL ___________

FIELD TRIP PERMISSION ____ NO MY CHILD DOES NOT HAVE FIELD TRIP PERMISSION

PICTURE RELEASE FORM____NO PHOTOGRAPHS OF MY CHILD MAY NOT BE TAKEN &

USED BY THE WAPELLO COMMUNITY SCHOOLS

INTERNET PERMISSION FORM ____NO MY CHILD DOES NOT HAVE PERMISSION TO ACCESS

THE INTERNET WHILE AT THE WAPELLO COMMUNITY

SCHOOLS

PARENT NAME _________________________________________________________________

                            PLEASE PRINT

PARENT SIGNATURE _____________________________________________________________

DATE ____________________________

THIS FORM IS ONLY TO BE SIGNED IF YOU

DO NOTGIVE PERMISSION

FOR YOUR STUDENT TO PARTICIPATE