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* 1. Student 1: first name

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* 2. Student 1: last name

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* 5. Please list additional siblings (and grade) for whom these same permissions apply.  (e.g. Lucy Segundo, grade 2)

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* 6. Confirmation of parent/guardian completing this form.

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* 7. I give permission to include my family's information for a school and/or classroom directory. Please fill out all of the fields you give permission to share in the school directory.  (Any field left blank will not be included in the directory.)

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* 8. The Thornton Creek Parent Group (TCPG) organizes fundraising and other ways for families to participate in supporting the school. They are focused on TC, and affiliated with the TC Site Council (of which all TC families are members). Would you like for your contact information to be shared for the purpose of receiving their newsletter and other information from TCPG?

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* 9. Thornton Creek PTA (TC PTA) is a parent organization that creates space and opportunities for all families to feel welcome, empowered and see themselves reflected in our public school. They foster and model equity while advocating for educational justice for all students and are affiliated with a national network of PTA organizations including the Seattle Council PTSA. Would you like for your contact information to be shared with TC PTA for the purpose of receiving their newsletter and other information from them?  Would you like to have your contact information shared to receive newsletters and other information from the TC-PTA?

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* 10. We are hoping to be able to resume "walking field trips" during this school year.  Does your child have permission to participate in a walking field trip led by their teacher and supported by approved adult volunteers?

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* 11. By completing and submitting this survey, I am acknowledging the following:

· I give permission for my child(ren) as indicated in the boxes above and for contact information to be shared as indicated.

Please write your name below as your electronic signature.  Please note that other forms need to be filled out on paper (pink FERPA form) or on-line and returned to your child's teacher.

Thank you for completing this survey.  Please go to thorntoncreekes.seattleschools.org to complete the Start of School packet forms online.
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