Environmental Club Member Sign-up 2022-2023
Please complete this form in the presence of your parent/guardian if you intend to stay after school for any service/club event at Discovery High School.
Email *
Last Name *
First Name *
Date of Birth (For emergency purposes) *
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Any known allergies? *
Any medical conditions? *
Current medications? *
Grade *
1st Period Teacher *
Advisement Teacher *
Which group are you trying to earn service hours for?  Select all that apply. If other, please specify. *
Required
Alternative Transportation Waiver: By typing your parent's name below, you are affirming your parents' knowledge of the transportation waiver for any event hosted by the environmental club this year. *
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Photo/Name Release: By typing your parent's name below, you are affirming your parents' knowledge of the photo/name release for any event hosted by the environmental club this year. *
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Liability Waiver: By typing your parent's name below, you are affirming your parents' knowledge of the liability waiver for any event hosted by the environmental club this year. *
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MEDICAL TREATMENT CONSENT: By typing the parent's name below, you give consent to the Activity Organizer or their representative to obtain medical care from any licensed physician, hospital or clinic for the above named student for any injury or illness that may arise during this activity. In the event of sickness or accidents, I will not hold the activity organizer, facility administration or group sponsor responsible. In case of sickness or accident, I authorize the calling of a medical doctor and/or providing of other necessary medical services. I agree to pay for those medical services that are deemed necessary by medical authorities. *
Emergency Contact (Name and phone number) *
I understand that my student MUST be picked up upon activity completion. If he/she doesn't have a ride, he/she will not stay after. *
Required
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