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Allendale Robotics 2022 Trip Permission Form

*Note: All students must have this filled out, even if 18 years old.*

First Member's Name

First Name*

Last Name*

Phone*
First Member's Date of Birth*
I certify that I am 20 years of age or older
First Member's Signature*
Second Member's Name

First Name*

Last Name*

Phone*
Second Member's Date of Birth*
Third Member's Name

First Name*

Last Name*

Phone*
Third Member's Date of Birth*
Fourth Member's Name

First Name*

Last Name*

Phone*
Fourth Member's Date of Birth*
Fifth Member's Name

First Name*

Last Name*

Phone*
Fifth Member's Date of Birth*
Sixth Member's Name

First Name*

Last Name*

Phone*
Sixth Member's Date of Birth*
Seventh Member's Name

First Name*

Last Name*

Phone*
Seventh Member's Date of Birth*
Eighth Member's Name

First Name*

Last Name*

Phone*
Eighth Member's Date of Birth*
Ninth Member's Name

First Name*

Last Name*

Phone*
Ninth Member's Date of Birth*
Tenth Member's Name

First Name*

Last Name*

Phone*
Tenth Member's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Event 1 Approval

Destination: St. Joseph District Event - St. Joseph, MI - St. Joseph High School

Depart Date / Time: March 10 - 3:00pm (Drive Team) OR March 11 - 6:00am (Remaining Team Members)

Return Date / Time: March 12 - 10:00pm

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: School Bus & Private Vehicle*

Fees: Included with Team Participation Fee (Needs to be paid prior to event)


*If the field trip is by private vehicle, please be assured that the adult driver has completed "Transportation by Private Vehicle Form" and will adhere to all district policies and procedures, including safety issues.

Deny
Approve
Event 2 Approval

Destination: West Michigan District Event - Allendale, MI - GVSU

Depart Date / Time: March 24 - 5:00pm, March 25 & 26 - 7:00am

Return Date / Time: March 24 - 10:00pm, March 25 & 26 - 7:00pm (Exception on March 25 for Scouting at HS until 10pm)

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: Personal Arrangement - Daily Drop off and Pickup required

Fees: Included with Team Participation Fee (Needs to be paid prior to event)


*If the field trip is by private vehicle, please be assured that the adult driver has completed "Transportation by Private Vehicle Form" and will adhere to all district policies and procedures, including safety issues.

Deny
Approve
State Championship Approval

Destination: Michigan State Championship - Saginaw, MI - SVSU

Depart Date / Time: April 13 - 3:00pm (Drive Team) OR April 14 - 7:00am (Remaining Team Members)

 Return Date / Time: April 16 - 12:00am

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: School Bus & Private Vehicle*

Additional Fees for States: TBD (Anticipated $150 due prior to trip)


*If the field trip is by private vehicle, please be assured that the adult driver has completed "Transportation by Private Vehicle Form" and will adhere to all district policies and procedures, including safety issues.

Deny
Approve
World Championship Approval

Destination: FIRST Championship - Houston, TX

Depart Date / Time: April 21 (Evening) or April 22 (TBD)

Return Date / Time: April 24 (TBD)

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: Charter Bus or Plane - TBS still, working on plans

Additional Fees for Worlds: TBD (Anticipated $350 due prior to trip)

Deny
Approve
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. Due to our event trips being excused form school, we need parents to complete the form regardless of the students age.


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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 20 years of age or older
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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