STUDENT NAME

2025-11-24 Permission Slip

https://storage.tally.so/a22ce339-dba2-4b99-ad98-d9019cbfdef0/Screenshot-2025-09-16-141537.png

I grant permission for photos of my child to be published in conjunction with Talent Search events.

I DO NOT grant permission for photos of my child to be published in conjunction with Talent Search events.

TRANSPORTATION - dropoff location

MAC - TRIO Building (former Law Enforcement Academy)

I will contact TRIO Talent Search at   573-518-2380 or TRIOTalentSearch@MineralArea.edu   to discuss other arrangements for Fredericktown, Arcadia Valley, Valley R-VI, Potosi, or Kingston

TRANSPORTATION - pickup location

HEALTH INSURANCE

HEALTH INSURANCE NAME

EMERGENCY MEDICAL PERMISSION

I grant permission to the TRIO Talent Search staff to act on my behalf in granting permission for the evaluation and treatment of medical problems for my child. In the event that I cannot be reached, I hereby give my consent to such treatment as deemed necessary (including surgery, x-ray examinations, and anesthesia to be rendered to said minor by a licensed physician or nurse).

I do not wish medical care of any kind except emergency care to be provided for my child.

OTC MEDICATIONS PERMITTED

DIETARY RESTRICTIONS

CONFIDENTIAL MEDICAL INFORMATION

Yes, I will provide more information by clicking the link after submitting this permission form.