Lockeland Design Center
After School Tutoring Club Parental Permission Form
Information provided on this form will be kept strictly confidential.
Public Notice/Accessibility Statement
To request an accommodation please contact your building principal, Christie Conyers Lewis, at 258-1330. (Interpreters for the deaf or hard of hearing must be requested seventy-two
[72] hours prior to the event.)
Lockeland Design Center Elementary School
PARENTAL PERMISSION FORM
Dear Parents,
Lockeland Design Center is offering an after school tutoring program this year. This program will run
from February 6- March 30, 2012 on Mondays and Tuesdays after school from 3:15 – 4pm.
If you are interested in your child participating, please fill out the bottom section of this notice and return
it to school as soon as possible.
Participant Name:
______________________________________________________________________
I give permission for my child (named above) to attend the Lockeland Design Center Elementary School
Tutoring Club on Mondays and Tuesdays after school from 3:15 – 4pm. Following the tutoring session,
your child must be picked up at 4:00 pm at the front entrance. Transportation is not provided from school.
The activities that will be taught will be used to further basic math comprehension and critical thinking
skills. The activities in this after school tutoring program will be kept age appropriate. This club is
completely optional.
__________________________________ ________________________ ________________
Signature of Parent or Legal Guardian Printed name of Parent or Guardian Date
EMERGENCY CONTACT INFORMATION
Resume Templates 1210 Document(s)
