(Please be advised, every child whom is not a current student, must bring this form or they will not be able to participate)

PERMISSION SLIP

I, ________________________________________hereby give Warrior Defense Martial Arts, Inc. permission

for my child,________________________________________ to attend a

Pizza Party at Warrior Defense Martial Inc. on

(day of week)____________________ (mm/dd/yy) ____/____/____.

Should injury occur, I hereby give my permission for trained medical personnel to administer necessary medical treatment.

Signed _____________________________________________ Date ______________________

(Parent or Guardian Name)

Emergency Phone Number: ________________________Email:_________________________

Contact Name if Emergency:______________________________________________________

Address:______________________________________________________________________