Epstein Secrets

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nt have any allergies? (if yes specify) f'Yes 0 No Allergy 1 18. Physician Name 1 J c•12,n APIA. 01/4.A Telephone Number Parental Consent for Release of Student Information I hereby give permission for the school or District to use my chikfs photograph, video Image, writing, voice recording, name, grade level, school n

redits n2 Ma tics 2 credits M 3 credits English 0000 Laboratory Science 2 credits Laboratory Science 3 credits Math or Science I credit Social Studies 3 credits Math 0.000 Social Studies 3 credits World History/Wodd Geography, 1 credit Laboratory Science 0.000 World History/World Geography,

dents illnesses, behavior issues, medications or physical limitations. student will use. 18. Physician Name Telephone Number Parental Consent for Release of Student Information I hereby give permission for the school or District to use my chid's photograph, video image, varkig, voice recording, name, grade level, school na

) O n () Reading Q-- )Q± if' A /F. iii English 4 J3 ,514 R-- ---- Mt- Spelling azz ip h ,.D4- Handwriting . 5 S Mathematics ge 6 A 'Social Studies A a- Aci- ,81" Ertl C Science / 5 5 S *Sri— ,r4 Health 4, a a- a- /7- Music 5. 5 sst- ,..5.4 5 II- ...0-: Art 5 SI- ,54- S )e--- .5/— P

student have any allergies? (if yes specify) 'Yes CI No Allergy 1 18. Physician Name 1 J ce-4., inn tc,k Telephone Number Parental Consent for Release of Student Information I hereby give permission for the school or District to use my chikfs photograph, video Image, writing, voice recording, name, grade level, school n