By checking the box below, I hereby grant the student listed above permission to attend the performance of "Newsies" at the Ben Lippen Performing Arts Center on Friday, February 11, 2022. I understand that he or she will be under the supervision of a Ben Lippen School teacher. I also grant permission for the student listed above to ride a Ben Lippen School bus to and from this event. In the event of an illness or accident, I hereby authorize Ben Lippen School to act on my behalf for the student named above in the securing of medical, surgical, and/or dental treatment. In the event of an emergency, I hereby give permission to the physician selected by Ben Lippen School to hospitalize, secure proper treatment for, and to order injections, anesthesia, or surgery for the student named above. I certify that I am the parent/guardian or have the legal ability to sign these authorizations on behalf of the student named above. I understand I am responsible for all expenses that the insurance does not pay. *
