NAVAJO NATION BAND

Parent Permission Form

As the parent or legal guardian of __________________________, I hereby give my permission for my son/daughter, _______________________________, to participate in a band activity that includes overnight travel and a parade performance to/from Mescalero, New Mexico.

Departure Time:  9:00 AM         Date:  07/03/09              Location: Bashas’ Parking Lot, Window Rock, AZ

Return Time:        7:00 PM        Date:  07/04/09              Location: WR Cinema Parking Lot, Window Rock, AZ

Activity:               The Navajo Nation Band will march in the annual Mescalero Celebration Fair Parade, Saturday, July 4, 2009.  A tentative itinerary is attached.

Cost:                   Meals are at your own expense.  Transportation & Lodging will be provided.

I give permission to the leaders of the Navajo Nation Band to render First Aid, should the need arise.  In the event of an emergency, I also give permission to the physician, selected by the Band Director, to hospitalize, secure proper anesthesia, order injection, or secure other medical treatment as needed.

I further agree to hold the Navajo Nation and band administration blameless for any accident that might occur during this outing except for clear acts of negligence or non-adherence to Navajo Nation policies and guidelines.

In case of emergency, I can be reached by phone at _____________________ or _____________________

If I cannot be reached, please contact _________________________ at __________________________

Signed: ___________________________________          Date: _____________________

               (Parent or Guardian)

Allergy or sensitivity: ______________________________________________________________________

                                    (list drug or environmental)

Medications & Instructions:  ________________________________________________________________

Form is required and must be completed for members age 18 and under before boarding the bus.

NAVAJO NATION BAND – Overnite Trip to Mescalero, NM

Departure Time:  9:00 AM         Date:  07/03/09              Location: Bashas’ Parking Lot, Window Rock, AZ

Return Time:        7:00 PM        Date:  07/04/09              Location: WR Cinema Parking Lot, Window Rock, AZ

Activity:               The Navajo Nation Band will march in the annual Mescalero Celebration Fair Parade on Saturday, July 4, 2009.  A tentative itinerary is attached.

Band Director:  Stephen Blatchford                               Cell Phone:  505-488-9557

Band Manager:  Valerie Harrison                                    Cell Phone:  505-409-5939

We will travel to/from Mescalero, NM.  Required to bring official NNB uniform, instrument, music and marching music lyre for marching parade performance.  Please make sure to bring a light jacket, something warm such as a light blanket and/or pillow, and an extra change of clothes for travel.  Keep personal possessions to a minimum.  NNB or the Navajo Nation will not be held responsible for breakage, loss or theft.

06/23/09