Carnival Themed Sup N Sing Permission Slip

Thursday, October 15, 2009

German Park

6-8p.m.

 

My daughter, ____________________________, has permission to attend the Oct. 15th Sup-n-Sing at German Park from 6-8pm.In case of an emergency I can be notified at the number below:

 

Home ________________________†† Cell____________________________

 

**If I can not be reached, please contact my emergency contact person listed below:

 

Name _________________________________________________________

 

Relationship_____________________________________________________

home _________________________ cell_____________________________

 

Dr.ís Name ______________________________ number _________________

 

Hospital preference ______________________________________________

 

 

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Parentís signature _____________________________ date______________

 

Number of girls attending ______ X $5.00 each = $ ________includes patch Number of adults attending ______X$3.00 each = $_________

Extra slices of pizza ___________X $1.00 each =$_________

††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††††† Total$_________

 

# of slices of Cheese pizza ______†† # of slices of pepperoni pizza ________