Permission Form

Solo SPOT BlueandBlack21st Century Program SPOT

First Name (required)

Last Name (required)

SPOT ID (if known)

Best contact name (in case of emergency (required)

Best Contact # - MOBILE Preferred (required)

Phone Type(required)

Best Contact EMail

Event Requiring Permission. Check list FIRST, If not there keep select Other and specify below (required)

If Other Specify Here

By checking the box I am allowing my child to attend the event specified in this form and assume responsibility for their behavior.
 Yes

By checking the box I am permitting my child to use SPOT provided transportation and accept responsibility for their actions .
 Yes

Things we should know

Print name of person signing this permission form, must be registered with The SPOT (required)

Please Provide Your Initials as your signature and consent

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