Department of The Army

U.S. Army Bull Dog Battalion, La Porte High School

Junior ROTC Program, La Porte Independence School District

301 E. Fairmont Parkway, Texas 77571

Parent/Guardian Release and Permission Form

La Porte Football Game

Date: ______

I give permission for my son/daughter Print Name:______who is currently enrolled in the La Porte Independent School District to attend the La Porte High Football Game. I fully understand that he/she will be, at all times, under the supervision of a cadre member. I also accept full responsibility for his/her actions and safety for the duration of the event and will not hold LPISD, the JROTC program, LPISD school officials, and/or the LPISD school board liable.

It is understood that all LPISD rules (conduct, zero tolerance, public display of affection, etc.) are in effect for the duration of this activity. If a student should violate the school rules with any degree of severity, appropriate disciplinary action will be taken. Finally, I understand that my child will be unable to attend this event if this permission slip is not signed.

This form also serves as my authorization for emergency medical care should my child become sick or injured. I authorize Major Crystal Armstrong, Sergeant First Class Montanez, or cadre members to obtain emergency medical treatment if required. I also authorize JROTC cadre to administer any over-the-counter medications and minor first aid (scrapes, cuts, sunburn, insect bites, etc.) as required unless stated otherwise on this form.

Signature of Parent: ______Date: ______

Signature of Student: ______Phone: ______

Date: ______

Name and phone number of family doctor: ______

Person to notify in case of emergency: ______Phone: ______

Any pre-existing medical conditions: ______Phone: ______

Any allergy to medications: ______

INFORMATION (Detach and Keep for Your Information)

Activity: Football Game

Location: La Porte High Bulldog Stadium, h, La Porte, TX 77571

Depart: LP JROTC CTE, 902 San Jacinto, La Porte, TX 77571

End Time: 9:30 pm

Return to Campus:

Contact numbers: MAJ Armstrong email- (School Phone 281-604-7740/Cell: 281-780-9561)

SFC. Montanez 281-604-7750 (School Phone) / 713-653-3166 (For official use only)

Uniform: