Tilden at Tilden End of the Year Picnic RSVP
Hello Tilden Families,

Thank you for taking the time to fill out the form below.

This form serves as a Permission Slip, Medical Consent Form, and RSVP.

If you have any questions, contact your campus.

Albany
Phone: 510-525-5506
Email: @adminalbany@tildenprep.com

Walnut Creek
Phone: 925-933-5506
Email: adminwc@tildenprep.com
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Parent(s) Name *
Student(s) Name *
How many family members will be attending, including your student? *
Do you authorize Tilden to take photos of your student during the event to use for promotional uses (social media, newsletters, etc.)
 *
Emergency Contact - Name, Relationship, Contact Number
 *
I authorize Tilden Prep to deduct $0 from my register for my student to attend this event. 

This is a free event.
 *
It is understood that with any activity there is a chance of accidents. In such an event, I consent to medical treatment and assume full responsibility and liability for any and all expenses, damage, accident, illness, injury or medical expense of and/or to my child or school property resulting from such participation.

I attest and affirm that the participant has no limitation that would prevent participation in the activity and I have not been advised or informed by anyone to the contrary. Every reasonable effort will be made by the school to contact parent/guardians before any medical services are provided. In cases where contact is tried but not made, I give consent for medical personnel to administer medical services as needed.

I have read and agreed to the above.

Electronic signature:
 *
I understand the picnic is at the Island Picnic Area of Tilden Regional Park from 11am to 2:30pm. *
I hereby grant permission for my student to participate in the Tilden at Tilden Picnic.

Electronic signature:
If you feel so inclined, what side dish will you be bringing? If none, answer N/A. *
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