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Parental Permission For Off-Campus School Activity: Student's Name - Grade

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St.

Augustine High School Instrumental Music


3266 Nutmeg St, San Diego, CA 92104  
619.764.5528 cau@sahs.org 
Cindy Au, Director 

Parental Permission for Off-Campus School Activity

Student's Name_______________________________________Grade__________
has my permission to participate in all school-sponsored activities related to the St. Augustine High 
School Instrumental Music Department. This includes, but is not limited to, football and basketball 
games, concert and jazz festivals, parades, and other off-campus performances (such as community 
outreach or OLP performances). This ​does not​ include overnight trips or unofficial “social” activities 
(such as lasertag, bonfires, disc golf and/or other non music-related events). 
 
I hereby release Cindy Au, her coaching staff, and St. Augustine High School from any responsibility 
in case of accident while performing in this activity. Permission is also given to administer first aid 
treatment or emergency medical treatment. 
 
I understand that permission is granted from August 20, 2018 - August 20, 2019. 

Parent/Guardian Printed Name_________________________________________

Signature___________________________________________ Date________________

In case of emergency, I may be reached at the following:


Cell: _______________________________ Cell: ______________________________

Home: ______________________________

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