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Please submit this form to give permission for your student to join a student club(s).

Parents and Students, please review these guidelines. If you agree to abide by these guidelines, please sign below.

(Non-Williamsburg Learning students have the option to join and participate in student clubs. They must agree to abide by all guidelnes)


I understand, that as a member of a student club, students have the following responsibilities:


- Students will be respectful of other students during club time, stay on topic, and support the club leadership.

- All club communication will take place in Canvas (Inbox, Announcements, Club Discussions.)

- Students will agree to and abide by all the club conditions listed on the Student Club page in Canvas.

- Students agree to show up for the meetings MOST of the time.

Parents are required to review the student club information in Homeroom before giving consent for their student to join a club.

Please select Minor in the options below.

 

Please select who will be participating...
AdultMinorAdult and a Minor
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First Student's Name
First Name*
Last Name*
First Student's Age Acknowledgment*
First Student's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Student's School ID
Student ID from SIS *
First Student's Signature*
Parent or Guardian's Email Address
Email*
Confirm Email*
Required Information

All clubs require parent permission for a student to join. By signing this I am stating that I have reviewed the clubs and guidelines found in homeroom, and am giving permission for my student to join the following club(s)

Which non-curricular club(s) are you giving your student permission to join? *
Anime/Manga
Art Club
Books vs Movies Club
Debate Club
Dungeons & Dragons Club
As the parent of the above student I give permission for my student to participate in the clubs selected in this form. (BE SURE TO SELECT 'YES' IF YOU ARE WANTING TO GIVE YOUR STUDENT PERMISSION)*
No
Yes
Date *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's School ID
Student ID from SIS *
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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