WAPELLO ELEMENTARY 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 NOT GIVE PERMISSION
FOR YOUR STUDENT TO PARTICIPATE