Mount View Middle School

Physical Education

Craig Blum

Weekly Homework Assignment:

Take your P.E. uniform home and have it washed.

Bring your P.E. uniform back to school on Mondays.

Perform 30 minutes of physical activity each day.

Activity: Archery

Instructor: Mr. Blum and Ms. Kenney

Time 2:30 PM-3:30 PM    

Session 1:  Dates: May 22, 26, 27, 28, 29

Session 2:  Dates  June 1, 2, 3, 4, 5

Choose only one session

Limit :25 First come, first serve

TO REGISTER:  Complete the Intramural Permission Form below and return it to one of the instructors on or before the first day of the intramural selection.

                                                   has my permission to participate in the school’s archery intramural during the 2008/2009 school year.  In giving permission for my son/daughter to participate in the program:

ÿ       I state that he/she does not have any physical condition that

        would prevent full, safe participation.

ÿ       I accept the responsibility of making transportation arrangements

for my child.  My child must be picked up at 3:30 PM.

ÿ       If your child is NOT picked up by 3:30 PM more than once,

he/she may be asked not to participate in this program.

ÿ       I realize that my child is required to be covered by school or home

        accident insurance policy.

Child’s Name:                                                                                                                                                                           

Please circle the intramural your child has permission to attend.

                Archery – Session 1                     Archery – Session 2                        

Address:                                                                                                                                                                                                 

Home Phone:                             Work Phone:                             Cell Phone:                             

Medical emergencies will be taken to the nearest hospital.

Child’s medical doctor:                                                                                                                                                               

List any pertinent health problems:  (i.e. allergic to bee stings and specific medication needed.)

                                                                                                                                                                                                                             

                                                                                                                

       Parent/Guardian Signature                                        Date