Parents Registration and Permission Slip to Participate

Dear Parent or Legal Guardian:

Your son/daughter, is eligible to participate in the STEAM class/Robolab/ FLL team *(needs to meet requirements*), Innovation class, etc. These activities will take place under the guidance and supervision of staff/volunteers from the Filipino Community of Seattle or FCS STEAM Camp programs: A brief description of the activity follows:

Activity Goal: SPIN STEAM Lab Camps at FCS, EAC, Bellevue, and SODO Makerspace

Date and time: Varies

Method of transportation: Parents Transport self/youth at location ( as determined by schedule)

Cost: $0 (Donations welcome)

Participant's Full Name *
Participant's Full Name
Birthdate *
Birthdate
Gender *
Address *
Address
Home Phone *
Home Phone
Cell Phone
Cell Phone
Class your interested in registering for *
Choose all that apply
Parent/Guardian Information
Parent/Guardian's Full Name *
Parent/Guardian's Full Name
Address (If different from student)
Address (If different from student)
Contact Phone Number *
Contact Phone Number
Does your child receive free/reduced lunch at school? *
Does your child live in section 8 housing? *
Does your child live in a temporary shelter? *
Medical Information
Please list in detail
Safe drop off and pick up process
Supervision will be provided to safely guide the students upon drop off and pick up during the sessions. It is required that parents of authorized persons physically come into the activity room to sign-in and sign-out their child at each session.
BESIDES PARENTS, PLEASE LIST NAME/S OF AUTHORIZED PERSONS TO PICK UP YOUR CHILD *
BESIDES PARENTS, PLEASE LIST NAME/S OF AUTHORIZED PERSONS TO PICK UP YOUR CHILD
Please note: Authorized persons must be an adults or an older sibling in high school or above. We will only allow your child to leave with the people you list here. A Photo ID or Password will be required.
Authorized Person 2
Authorized Person 2
ELECTRONIC SIGNATURE of Parent/Guardian 1 *
ELECTRONIC SIGNATURE of Parent/Guardian 1
ELECTRONIC SIGNATURE of Parent/Guardian 2
ELECTRONIC SIGNATURE of Parent/Guardian 2
Emergency Contact Name *
Emergency Contact Name
Contact Number *
Contact Number
Address *
Address