POLICY AGREEMENT

I have carefully read the East Grand Rapids High School choir handbook. I agree to its contents. I acknowledge that I will follow all program policies by signing my name below:

Student Name Printed____________________________________________

Student Name Signed____________________________________________

Parent/Guardian Name Printed_____________________________________________

Parent/Guardian Name Signed_____________________________________________

COMPREHENSIVE PERMISSION

By signing above, I also give my permission for my son/daughter to attend all activities related to the East Grand Rapids High School Vocal Music Department during the 2011-2012 school-year. I understand that school rules are applicable to all school-sponsored choral activities. In the event of injury or illness to my child while under Dr. Borst’s supervision, I know that I will be contacted for permission and directions regarding emergency treatment.

Does your child have any medical or personal issues of which Dr. Borst should be aware?

Does your child take any medications of which Dr. Borst should be aware?

If yes, please describe:

Does your child need assistance in administering this medication? Yes___________No____________

THIS FORM MUST BE HANDED-IN TO YOUR CHOIR TEACHER

BY FRIDAY, SEPTEMBER 16