Parent/guardian authorization for winter afterschool programs SY22-23 (Middle School)
Meridian is excited to offer 8 clubs at the Middle School this winter. Below you will find a weekly schedule of all available clubs. Please complete one authorization per student. Students can register for multiple clubs, as long as they do not meet on conflicting days. 
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Email *
Student's name: *
Student's Grade *
Student's homeroom teacher: *
Weekly Club Schedule
I authorize my student to take part in the following club(s): *
Required
Parent/ Guardian Authorization and Acknowledgement of Risk
I, as the parent or legal guardian, give permission for the student named above to participate in this afterschool program. I have read and understand the purpose of the program. I understand that participation in clubs and sports teams is open to students in eligible grades with a 2.5 or higher GPA; students with less than a 2.5 GPA may be suspended from participating in afterschool programs without additional notice. I understand that if my student is invited to participate in intervention tutoring at any point during the school year, my student’s regular participation in intervention tutoring takes priority, superseding participation in any after school club or sport. Should participation in the after school program involve activities off of the school premises, neither Meridian nor its employees and volunteers have any responsibility for the condition or use of any non-school property. *
Medical Authorization
I understand the school nurse’s hours of operation are 8:00 AM – 4:30 PM. The school has my permission, when I (or my student’s physician) cannot be contacted, to take my child to the emergency room of the nearest hospital (in a private automobile or emergency vehicle). I further provide the hospital and its medical staff my authorization to provide treatment, which a physician deems necessary for the well-being of my child.
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Notice of Cancellation
Please note that the school and/or afterschool sponsor reserves the right to cancel any meeting after school program when needed. If a club meeting is cancelled, your student must be picked up on time, at the school’s normal dismissal time. I understand that the school will notify me and/or other authorized persons as soon as possible by phone, text message, email, or Remind about the cancellation of the day’s afterschool program(s). By checking the box and signing below, parents/guardians acknowledge that they have read this notice and accept responsibility for any late pick-ups.
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When the afterschool program is over, the student will be: *
By typing your name below, you are signing this form electronically and acknowledging that your electronic signature is the legal equivalent of your manual signature.
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