Chandler Preparatory Academy

1951North Alma School Road

Chandler, Arizona 85224

(480) 855-5410

Extracurricular Activity Permission Form

This document is intended to inform the parents of Chandler Prep Builders Club about an upcoming social event being offered. In order to attend this event, each student’s parents must sign this permission form, and the studentmust turn it in to the front desk or Mrs. Goodwin on or before Wednesday, March 18.

Date and Time of Event: Wednesday, March 18 - 3:40 pm to 5:30 pm

Nature of the Event:CPA Builders Club “Social at Apache Park”

Method of Transportation: Students will meet Mrs. Goodwin in the CPA Forum at 3:40 pm. We will leave CPA at 3:45 to all WALK together approximately 7-8 blocks to Apache Park (Knox and Hartford). Parents also have the option of driving their child to the park and waiting for us there.

Location:Apache Park, 799 W. Knox Road (address for tennis courts nearest the parking lot). From Chandler Prep, go south on Alma School to Knox Road, turn left (east) on Knox Road and go 2-3 blocks. When you reach Evergreen Street, there is a raised crosswalk. Turn right (south) just before the crosswalk. It will look like you are driving down an alley, which leads to the parking lot for Apache Park

Required Student Materials: Students may change into appropriate (modest) “play” clothes at CPA if they would like. They must carry their clothes and other belongings with them to the park, however.No spaghetti strips, halter tops, short-shorts, or inappropriate slogans on t-shirts or other clothing.

Cost: None – hot dogs, chips, cookies, and drinks will be provided.

Other info: We will have a variety of sports equipment and board games, so students can choose to play whatever they would like. We will eat at approximately 5:00 pm at the park.

* Parents MUST pick their child up at Apache Park between 5:30 and 6:00. You must park and come past the tennis courts to the ramadas to pick up your child, so we can see who they are leaving with. Please do not call your child to come meet you at your car. If your child has your permission to ride home with another parent, you MUST indicate that on the form below.*

Contact: Mrs. Goodwin at or cell phone 480-326-7848. You may also visit and click on the Builders Club page.

(rip off the second page and return – keep this page for information purposes)

This page must be completed and signed by a parent of the participating student:

As the legal parent/guardian of the student named below, I grant permission for my child to participate in the following event –Chandler Prep Builders Club Social at Apache Park. I will not hold Chandler Preparatory Academy or any CPA faculty member, sponsor, or volunteer chaperone legally liable for any injury or illness incurred by my child during his/her involvement in this optional social event, including travel to and from. Furthermore, I grant permission for any necessary medical treatment to be administered to my child in the event of a medical emergency.

Student’s Name (please print): ______

Parent/Guardian’s Name (please print): ______

Parent/Guardian’s Signature: ______

Date: ______

Emergency Contact Phone Numberduring that time: ______

Check ALL that apply:

My child will be walking with you to Apache Park. ____

I will be driving my child to Apache Park and wait for you there. ____

I will be picking my child up at Apache Park and will park and walk over to let you know I am there. ____

My child has my permission to ride to Apache Park AND/OR ride homewith another parent. ____

(circle one or both)

That parent’s name (print) ______

That parent’s child’s name (print) ______

Signed permission slip must be returned to front desk or Mrs. Goodwin on or before Wed. March 18.

Please call (480)326-7848 or email Mrs. Goodwin with any questions ()