Southern University Alumni
Recruiting Trip Rules/Permission Slip
To: Parents/Students
From: Future Jag Committee
Subject: Campus Tour
Parents, we would like to express our thanks to you for allowing us the opportunity to expose students to campus life at Southern University. Below are the rules/guidelines that students are expected to follow. Student must sign and return this form.
| Student must arrive prior to 5:00 AM on Saturday, October 8th, 2011 so we can arrive on campus for 9:00 AM. |
| Students should come dressed for the tour. No pajamas. We are going directly to the campus. |
| The group will remain together unless the chaperones give you different instructions. |
| Respect yourself, other students, chaperones, bus driver, campus representatives and anyone else you may come in contact with during the trip. |
| Alcoholic beverages and smoking are not allowed. |
| Cursing and abusive language will not be tolerated. |
| Nametags must be worn and visible. |
The above guidelines/rules are for your safety and the group's enjoyment. Parents will be notified immediately if there is a problem.
As the parent/legal guardian of _______________________________________, I grant my permission for said child to attend the Future Jags - Southern University Campus Tour and Game Day Trip in Baton Rouge, Louisiana, Saturday, October 8, 2011. The meeting time will be 5:00 AM at "The Power Center" parking lot, 12401 S Post Oak Rd and the pickup time will be 1:00 AM at The Power Center.
I understand and acknowledge that participation in the activities involves inherent risks of injury to my child including risks associated with transportation by motor vehicle. I agree to indemnify the Southern University Alumni Federation – Houston Chapter Representatives for any costs or expenses arising out of my child’s participation in the activities including the cost of any medical care given my child or any expenses or fees incurred in any lawsuit arising as a result of any damage or injuries caused by my child in the course of his or her participation in the activity.
I further give my consent
that in my absence the above-named minor be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named minor.| MEDICAL INFORMATION | |
| Known allergies including any allergies to medicine (Continue on back of form if needed) | |
| Any other medical problems which should be noted (Continue on back of form if needed) | |
| Student Signature | Date |
| Parent Signature | Date |