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Trimester 2 Intramurals Permission Form
This document should be completed ONLY by the parents/guardians of DAMS students.
With the exception of Color Guard, all intramural activities run until 4:15 PM.
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* Indicates required question
Email
*
Your email
Student LAST name
*
Your answer
Student FIRST name
*
Your answer
Grade
*
7th
8th
Parent/Guardian name
*
Your answer
Emergency phone number
*
Your answer
Family Physician
*
Your answer
Please check the appropriate coverage:
*
We have school insurance coverage for our son/daughter.
We have a separate health/accident insurance policy.
We give permission for our child to participate even though he/she has no insurance coverage.
Required
Please check the appropriate mode of transportation:
*
My child will be a car rider.
My child will ride the activity bus.
My child is permitted to walk home.
Required
By checking the box below, I acknowledge that, should my child not be picked up by 4:50pm, he/she will ride the activity bus.
*
Yes, I agree
Required
My student has permission to participate in the following after school program(s):
*
D&D (Dungeons and Dragons) with Mr. Himes- Mondays
Card Games Club with Mr. Gillis- Tuesdays and Thursdays
Ping Pong Club with Mr. Himes- Tuesdays and Thursdays
Running Club with Mr. Abeles- Wednesdays starting 12/7
Homework Club with Mrs. Ross- Wednesdays *Note, this is a quiet place to complete work, not get help from your teachers.
Chinese Language and Culture Club with Mrs. Kuang-- Wednesdays
WAM (We All Matter) with Mrs. Eckert-Wednesday
Required
By clicking the box below, I give permission for my child to participate in the selected intramural/club programs at Dallastown Area Middle School.
*
I give permission
Required
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