JA BizTown Permission Slip and Parent Volunteer Form

Your child is scheduled for our visit on ______. We will be leaving school at 8:05 a.m.and returning at 3:05 p.m.

Students are videotaped and photographed daily by the student Camera Operator working at JA BizTown. This videotape or photographs are given to the school for later viewing in our classroom. On occasion, the JA BizTown experience may be photographed and/or videotaped by external media for use in communications and marketing materials. If Junior Achievement is aware of this filming, it will notify schools in advance.

Please complete the form on the back of this page to give permission for your child to accompany us to JA BizTown. Inform us of your preferences for including or omitting your child from any such photography on this form.

Students will be eating a bag lunch during our field trip. Drinks will be provided. Please indicate whether you would like tosend alunch to school with your child, or purchase a cold lunch through the school lunch program.

This form must be signed and returned to us along with the $25 fee by Wednesday, April 13th.

Student Name: ______Date: ______

Parent Signature: ______School: Lake Mills Middle School

Parent Name: ______

CHECK ONE:

____Yes, my child has my permission to accompany the class to JA BizTown on ______and I understand that he/she may be photographed and/or videotaped.

____No, my child cannot accompany the class to JA BizTown.

____Yes, my child has my permission to accompany the class to JA BizTown, but I request that efforts be made to exclude my child from any photography or videotaping where he/she may be easily identified.

CHECK ONE:

____ I will provide my child with a cold lunch for the field trip.

____ I would like to purchase a lunch through the school lunch program for the field trip.

______

CHECK ONE:

___ I am unable to volunteer at this time.

___ Yes, I want to volunteer for JA BizTown and I agree to participate in the requiredon-line training. I also understand that I will be responsible for providing my owntransportation to and from JA BizTown and will need to arrive there by 8:00 a.m. (Additional Information will follow.)

Parent name ______

Parent email address ______