Calvert High School 520 Fox Run Boulevard Prince Frederick, MD 20678-4090 Principal: Steven V. Lucas SNSI: CDR Dan Kletter, USN-Ret. NSI: CWO3 Ceylon Williams, USMC-Ret.  

School Main Office: NJROTC Office: Cell: Cell:

(410) 535-7330 (410) 535-7349 (443) 684-2155 (443) 295-3152

NJROTC Participation Permission Form

General Info:

USNA Football Game 10/22/2016 The CHS NJROTC is going to _____________________________________ on __________________ JROTC Day / USNA Homecoming Football Game for _________________________________________________________.

Transportation is ✔ Provided Cadets provide own transportation Privately Owned Vehicle(s) (POV) ✔ School Bus Commercial Bus / Van

Not Provided Rental Car / Van Commercial / Military Air Boat / Ship Train / Subway

Depart / Return Info:

0800 10/22/2016 CHS Muster location is ____________________________ at ___________ hours on ____________________. CHS ~ 2000 10/22/2016 We will return to _____________________________ at ___________ hours on ____________________.

Uniform for Muster: Navy Service Uniform (NSU) NJROTC issued PT shorts NJROTC issued uniform shoes (Oxford) ✔ Unit NJROTC Hoodie Shirt Meal Arrangements: ✔ Eat before coming to muster ✔ Bring money for meal(s) No meals required

✔ NJROTC issued khaki trousers / pants ✔ Civilian khaki colored trousers / pants Hair up (Females) Other (Specified below)

Any short sleeve unit shirt and NJROTC hoodie sweat top with khakis. Cost is $20 for ticket and bring money for meals (estimate $25 lunch & dinner), snacks, gifts etc.

10/20/2016 Please return signed permission slip by _____________ or Cadet may not be able to attend. In case of emergency, the SNSI and/or NSI can be reached using number(s) above. By my signature below, I understand and accept the following conditions: (1) I understand that my child will be responsible for any personal articles my child chooses to bring, including jewelry. School employees and chaperones will not be responsible for the loss or damage to any of my child’s personal items. (2) I understand that all applicable school rules will be in effect while my child is on this trip, including prohibitions against the possession or use of tobacco, alcohol and controlled dangerous substances. I also understand that my child will be expected to follow the directions of Calvert County Public Schools’ employees and chaperones. Consequences for violations of school rules or directions could result in appropriate discipline as provided by Calvert County Public Schools Code of Student Conduct, as well as appropriate discipline of my child during the trip, up to and including the removal of my child from the trip at my expense. (3) This trip is subject to last-minute cancellation by Calvert County Public Schools for various reasons related to student safety, medical issues or other concerns. Please recognize that Calvert County Public Schools has, on several occasions since September 2001, canceled all school trips (either in-county, out-of-county, or both) due to local or national circumstances. Calvert County Public Schools, its agents, and employees, will NOT be responsible for any non-refundable monies paid by students, parents or guardians in the event this trip is canceled. While the school is willing to help students with the logistics of the trip, the school assumes no financial responsibility in the event the trip must be canceled. The world situation today makes us cautious in planning events months ahead. You need to be aware of the personal and financial risks and responsibilities that you are undertaking if any monies are paid for this trip. (4) I understand that if a student cannot attend the trip for a medical reason that cannot be delegated to an unlicensed person, and the student’s parent cannot attend, or if Calvert County Public Schools is unable to provide a medically licensed person to meet the student’s needs, the trip will be cancelled. (5) I understand that should my child be unable to participate in this field trip due to illness or an emergency situation, that Calvert County Public Schools will not be liable for refunding monies paid by the student. (6) In case of an emergency or serious illness, I hereby authorize school employees and chaperones to arrange medical treatment for my child, and I request that the school, either prior to treatment when practicable or as soon afterwards as possible, contact me or another person previously identified to the school as an emergency contact.

---------------------------CUT HERE AND RETURN BOTTOM PORTION-----------------------------I give permission for Cadet ___________________________ to go with the Calvert JROTC Day / USNA Homecoming Football Game 10/22/2016 for _______________________________. High School NJROTC on ____________

I will pick up the Cadet promptly at the return time or has permission to drive home. ____________________________________ (Emergency Contact Number During Event) _____________________________________ (Parent / Guardian Name (Printed))

_________________________________ (Parent / Guardian Signature)