School Sponsored Activity Parental Authorization

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Pursuant to Rule 6A-10.089 (5), F.A.C., Seminole County Public Schools requires parental authorization prior to students participating in school sponsored events and activities. Each student participating in the event or activity listed below must have this form completed and submitted prior to participating.

Description of the Event or Activity: Health and Wellness Club

Date(s) and Time(s): Every Monday during lunch. Occasional after school meetings as needed.

Location: Room 10-208 and the multipurpose room

Sponsors/Guests: Nicole Avella, Lake Howell District Mental Health Counselor. Shannon Stieg, Lake Howell New Horizons Counselor. Volunteers from Ali's Hope Organization and Volunteers from Lake Howell PTSA.

Student Supervision: Student supervision will be provided by school personnel commensurate to the attendance at the event.

Email *

Student's Last Name *

Student's First Name *

Student ID Number *

Enter the name of the parent or guardian completing this form. *

Digital Signature: By entering my full name below, I give permission for my student to participate in this School-Sponsored Event/Activity. *

A copy of your responses will be emailed to the address you provided.

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