Fall 2022 Norwin Band/Colorguard Medical Permission Form
This form grants permission to the directors of the Norwin High School Band, Timothy Daniels, Brandon Kandrak, Heather Shrump, as well as the Band and Guard Medical personnel, to act as guardian/spokesmen in granting permission for emergency hospitalization/treatment (including anesthesia for your child, while he/she is traveling with the above named group, if the situation becomes necessary.  

A copy of your answers will be sent to the email provided below.  Please retain this email for future reference.


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Email *
Student First Name *
Student Last Name *
Student Birth Date *
MM
/
DD
/
YYYY
Parent First Name *
Parent Last Name *
Parent Cell Phone Number *
By checking yes below, this is considered an electronic signature and grants permission to the Directors and Medical staff of the Norwin Band to act as guardian of my child if a medical event arises while under their supervision. *
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