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We need these actual forms signed and on file at the school.
 Please fill out these forms, print, sign, and then mail them to the school. 
To Update Emergency Information

 
 

  Yakima Adventist Christian School

1200 City Reservoir Road
Yakima, WA 98908
509-966-1933
  
Field Trip Permission
 
Your signature below grants permission for your child, named below, to go on the various field trips planned during this entire school year. You will be notified in advance of each field trip, usually by a note sent home with your child.
 
 
My child,  may go on the field trips planned for this school year.
 
 
 
Signed _______________________________________________    Date ____________







 


 
 Student Last Name                                             Student First                     

IN CASE OF EMERGENCY PLEASE CONTACT:
 
Parent            
Home Phone    Work Phone    
Cell Phone   Other Phone    
       
Other than  Parent            
Home Phone   Work Phone                
Cell Phone   Other Phone            
           
Doctor               
Phone    
       
                CONTINUING CONSENT TO TREATMENT               
AND AUTHORIZATION TO RELEASE INFORMATION
 
            We, the undersigned parent or guardian of  , a minor, do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital service that may be rendered to said minor under the general or special instruction of   , M.D., or any physician the school or organization may call, whether such diagnosis or treatment is rendered at the office of said physician or at a licensed hospital. It is understood that reasonable effort will be made to contact the doctor listed above before any other physician is called by the school or other organization.
                It is further understood that this consent is given in advance of any specific diagnosis or treatment which might be required and is given to authorize Yakima Adventist Christian School or the physician to exercise their best judgment as to the requirements of such diagnosis or treatment.
                This consent shall remain in continuous effect until revoking in writing and delivered to Yakima Adventist Christian School
                We, the undersigned hereby authorize any hospital, physician, or other person who has attended or examined the minor to furnish to General Conference Insurance Service, or its representative any and all information with respect to any illness, medical history, consultation, prescriptions or treatment, and copies of all hospital or medical records. A copy of this authorization shall be considered as effective and valid as the original.
 
Signed by:

Father  __________________________________________________ Date ____________
Mother __________________________________________________ Date ____________
Guardian __________________________________________________ Date ____________
Address __________________________________________________    
  __________________________________________________    

 
 
PERMISSIONS
Yakima Adventist Christian School

 
Please read and mark the information below and then sign in the space provided.

 
 Finanacial Information
    I have read pages 9 through 12 of the handbook and understand I
am responsible for tuition and other fees as explained.
 
Academic Attire
    I have read pages 22 and 23 of the student handbook and will
       help my student follow the YACS Academic Attire Policy.
 
Citizenship
    I have read pages 23 and 24 of the student handbook and will      
help my student follow the YACS Citizenship Policy.
    I have read page 33 of the student handbook and will abide by the
      commitment statements.
 
Special Activities
While Yakima Adventist Christian School will do it’s best to see that students are safe, I understand that all sports activities have an inherent risk of injury. I give permission for my child to participate in:
  Intramurals (gr 5-10)                                  Jump Rope (gr. 1-6)
           
Media Permission
I give permission to use pictures of my student  :
  In papers, magazines, calendars
  Online in the school or other church related sites
    In group pictures only
    Not at all
 
Volunteer (policy on pages 17-18 of the student handbook)
Every volunteer at YACS must go through orientation and training. There is also a short recertification course.
 I want to be a YACS volunteer. Please send information.
 I want to continue to be a YACS volunteer. I completed my training in   .
I want to continue to be a YACS volunteer. I competed Level One training in  
         and now want to become a Level 2 Volunteer.
 
Signed by:
 
Father ______________________________________ Date  _________
 
Mother ______________________________________  Date _________
 
Legal Guardian _______________________________  Date _________