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Dubois Elementary School

120 South Lincoln Ave
Springfield, IL 62704

Spfld. Dist 186 4th/5th Cross Country Meet

October 11, 2013

Springfield District 186 is sponsoring the 4th/5th Grade Cross Country meet at Lincoln Park. It will be October 29th. The girls will run at 4:30 and the boys will run at 4:45. It will be a 1 mile run. Certificates of Participation will be handed out to all runners.

Springfield Public Schools
4/5 Grade Cross Country Meet

WHERE: Lincoln Park

WHEN: Tuesday, October 29, 2013

TIME: 4:30 p.m. (girls) 4:45 p.m. (boys). Students will be responsible for their own transportation to and from the meet

PROGRAM: This Cross Country Meet is sponsored by the Springfield Public Schools.
PARENT PERMISSION FORM - (Please return to the main office)
NAME: ___________________________________________________ GRADE: _____________________ SCHOOL:________________________________________________________________________________ I hereby giver permission for my child to participate in the Springfield Public Schools Cross Country Meet described above. I understand that all codes of conduct and behavior guidelines, including the District 186 Informational and Discipline Handbook are in effect. In the event of an accident to my child and I cannot be reached immediately, I hereby authorize the staff member in charge to provide first aid treatment deemed necessary and appropriate, including emergency hospitalization. I shall be notified as soon as possible of any such action. All participants will receive a certificate of participation. No places will be kept. No medals/ribbons will be awarded.
SIGNATURE PARENT/GUARDIAN: ___________________________________________________________
CONTACT NUMBER: __________________________ DATE: _______________________