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Get Uil Permission Slip

D activity. Please complete this form to provide the field trip/activity leaders with information relating to your child. List any physical limitations (temporary or permanent): List any current medications (prescribed or over the counter) taken: List any allergies including reactions to medications, food, insects, and environment: Name of child s physician: Phone: Insurance company: Phone: Policy Number: ASSURANCES My signature below indicates that I give my child permi.

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