I d a h o O r c h e s t r a I n s t i t u t e P e r m i s s i o n F o r m ??2017-05-22I d a h o O r c h e s t r a I n s t i t u t e P e r m i s s i o n F o r m S t u d en t ’ s Name: _____ P h o n e: _____ S t reet

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    12-May-2018

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<ul><li><p>IdahoOrchestraInstitutePermissionForm</p><p>StudentsName:__________________________________Phone:____________________Street:___________________________________________________________City:______________State:____Zip:_______E-mail:______________________Parentsname(s):(ifunder18)_____________________________________________________Parentsphonenumber(s)___________________________________________Parentsemail(s)___________________________________________________InsuranceCompany:___________________________PolicyNo.:______________ </p><p>PermissionandMedicalTreatmentWaiver</p><p>(Over18,filloutwithyourname)</p><p>I,___________________________,theparent/guardianof______________________doherebygivemypermissionforhim/hertoattendIdahoOrchestraInstituteandtobetreatedforamedicalemergencyinmyabsencewhileparticipatinginIdahoOrchestraInstituteactivities.EmilyWhiteoranyassistantatIdahoOrchestraInstitutemayactasanagentinmyabsence.Incaseofaccident,IdonotholdIdahoOrchestraInstitute,SawtoothCamporanyofitsstaffersponsible.Incaseofemergency,ifIamnotavailableattheaboveaddressandphone,pleasecontact:Name:_____________________________________Phone:____________________Parent/GuardianSignature:_______________________________Date:___________SpecialDietaryNeeds:__________________________________________________Allergies:______________________________________________________________</p><p>STUDENTAGREEMENT:</p><p>IunderstandthatIamattendingIdahoOrchestraInstitute.Iagreetofollowanyandallrulesandparticipatetothebestofmyabilityinallcampactivities.IalsounderstandthatanyviolationofruleswillresultinmyimmediateexpulsionfromIdahoOrchestraInstituteandthatIwillbesenthomeatcosttomyparents/guardiansStudentsignature___________________________________Date__________________Parent/guardiansignature_____________________________Date__________________</p></li></ul>

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