VIP KID TASTER PERMISSION FORM

Student Name:__________________________________________________ has permission to participate in the Student Taster Program at McAuliffe Regional Charter Public School. I agree that my child has no food allergies or intolerances that would prevent him/her from participating in this program. I understand that all school rules are in full force during this session. I do hereby expressly and knowingly release and discharge the school, its employees and agents fro any and all liability arising out of injury or harm which may result to my son/daughter in the course of his/her participating in this program.

Date: __________________________

Signature of Parent/Guardian: _____________________________________________________

Printed Name of Parent/Guardian: _________________________________________________

Phone during the day: _________________________ Home Phone: ______________________