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EXCEL - Student Convention Parent Permission Form
Due Date:
February 28th with Student Registrations
Parent Permission is included on the student registration form. This form is not necessary if you already filled out and signed this with student registration.
How many children are attending from your family?
*
Please select
1
2
3
4
5
1st Child Name
*
First
Last
2nd Child Name
First
Last
3rd Child Name
First
Last
4th Child Name
First
Last
5th Child Name
First
Last
Parent/Guardian Name
*
Email
*
Phone
*
###
-
###
-
####
Alternate Phone
###
-
###
-
####
School/Homeschool Name
*
School staff member(s) responsible for my child(ren)
Not necessary for homeschools.
First
Last
First
Last
First
Last
Alternate Emergency Contact
First
Last
Relationship to Student(s)
Phone
###
-
###
-
####
Alternate Phone
###
-
###
-
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*
I, person giving consent, hereby give my permission for the above listed students to attend the Oregon Excel Student Convention in Aloha, Oregon, under the supervision of the school staff member(s) listed above.
*
I hereby give permission for medical treatment to be obtained for my child(ren), if necessary. Known allergies to medications and all medical conditions requiring special treatment are listed below.
Medical Information
List any known allergies to medications and all medical conditions requiring special treatment for all of the students listed on this form.
*
I agree to abide by and support the Oregon Excel Convention's procedures and policies published in the Convention Guidelines.
*
I hereby release OR Excel and its affiliates from responsibility and liability for any medical expenses, injury, or damages incurred by my child(ren) during their stay at the Convention or their travels to and from the Convention.
Signature
*
Clear
