Opportunity Hall Permission Slip

Opportunity Hall meets on Tuesdays from 3:00 p.m. to 4:30 p.m. in media from 9/25/24- 5/21/25.
If you are interested in this support, please complete the following information to register your student for Opportunity Hall.

Student Name Student Name First Last
Student Number
Area of Support
Parent Name Parent Name First Last
Phone Phone - ### - ### ####
Email
Name of person will pick up your student at 4:30 p.m.
Parents draw your signature into the box below to give permission.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.