Form: Athletics Permission Slip

Form: Athletics Permission Slip

Student Information

Parent or Guardian Information

Medical Information

Sports Information


Coaches, parents, and students will work together to insure that all students can be transported to away games. The use of private care will be a necessity, and proper paperwork will be completed by all drivers and returned to the office upon departure. The coaches will notify parents/students at least twenty-four (24) hours in advance of ride assignments, departure and arrival times, and location/maps of activities.

Payment Information

Make Check Payable to:
Emmaus Lutheran School

Mail your Check to:
Emmaus Lutheran School
40 South Almansor Street,
Alhambra, California 91801

Authorization Information

The undersigned hereby requests and gives permission to allow: above mentioned student to participate in the above mentioned sports activity.

I, the undersigned, waive and release any and all rights and claims for damages I may have against Emmaus Lutheran School and all staff members of the 2017-2018 Sports Program. I acknowledge that I am aware of the risk involved and that the above participating student is in good health and in case of medical emergency I authorize the coaching/school staff to obtain medical/dental care for the participant named above.

Emmaus Lutheran School | 840 South Almansor Street, Alhambra, Ca. 91801 | 626-289-3664