cnh kiwin's official fundraising manual 2015-2016
DESCRIPTION
Made by your 2015-2016 District Treasurer & the Treasurer's Committee for CNH KIWIN'S Club TreasurersTRANSCRIPT
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Hello CNH KIWIN’S!
I present to you the Official 2015-2016 Fundraising Manual for I present to you the Official 2015-2016 Fundraising Manual for our KIWIN’S Ohana. Everything I have included in this has been specifically targeted towards the needs I have identi-fied with each division’s clubs as well as our specific empha-ses. In here you will find not only official guidelines on the pro-cedures of holding a fundraiser, but also smart tips and tricks passed down from myself and other past Club Treasurers. We know better than anyone that holding fundraisers can be a seemingly daunting task, but with the breakdown of each step, it should be easier to process and deliver. I dearly hope all clubs will find this manual useful and be able to reference it as needed.
Yours in Service,Kathy BuiCal-Nev-Ha KIWIN’S District Treasurer 2015-[email protected]
table of contentsWhat You Can Fundraise For......................................4
Planning a Fundraiser..................................................6
Small Fundraisers..........................................................8
Medium Fundraisers...................................................10
Large Fundraisers.......................................................12
How to Donate to Project Eliminate.........................14
How to Donate to Pediatric Trauma Program.........15How to Donate to Pediatric Trauma Program.........15
Solicitation Letter Examples......................................16
Working with your School..........................................18
Forms, Forms, Forms............................ ......................19
Kiwanis Internat ional and UNICEF have part-nered up to e l iminate Maternal & Neonatal Tetanus (MNT). Every 11 minutes, a newborn dies from neonatal tetanus, a d isease which makes them extremely sensit ive to l ight and touch and gives them convuls ions. For $1.80 you provide a mother and her two chi ldren vaccinat ions for MNT and the shots wi l l cover vaccinat ions for MNT and the shots wi l l cover the mother for up to 10 years, prevent ing any future chi ldren from contract ing the disease. This is year with be the f inal push to reach our CNH KIWIN’S Distr ict Goal of ra is ing $20,000 for the El iminate Project so work hard treasurers! #ODFL, One Dol lar For L i fe L ive2Learn focuses on chi l -
dren pr imari ly from the ages of 5-9 to promote educat ion and bui ld l i terary ski l ls . Al-though this emphasis is usu-al ly supported for through service projects, you can
also fundraise to donate to schools, l ibrar ies, or other
educat ional fac i l i t ies to sup-port the cause.
Pediatr ic Trauma affects chi ldren from infancy to the age of 19. Trauma can be the result of motor vehic le acc idents, physical abuse, drowning, acc idents, fa l ls , and animal b i tes, making i t the leading cause of chi ld death in the United States. To prevent these acc idents States. To prevent these acc idents and injur ies from occurr ing, we help ra ise funds for Pediatr ic Trauma and educate through awareness.
4
Club funds can be raised for
things like reimbursement to
buy supplies for a Club Rush,
for food for a meeting, for
awards and prizes for mem-
bers, for banquets, etc.
DCON can be pricey for some mem-
bers, so encourage more members
to go by fundraising for it to bring
the price down! You can also fund-
raise for things like your spirit wear
for DCON, food for the bus ride, etc.
5
PUBLIC FUNDRAISERSKiwanis policy states that profits from Kiwanis policy states that profits from fundraisers open to the public (anyone outside your KIWIN’S club) are not to be used on personal club expenditures that have no direct impact on our projects/emphases. These funds can only be used for donation or subsidizing District Convention or Fall Rally.
fundraiser
77
BE KNOWLEDGEABLE
Know what you are fundraising for (ie. Club funds, DCON,
The Eliminate Project, PTP, Live2Learn)
Make sure all board members are educated and wellMake sure all board members are educated and well-
versed about the project/emphasis your fundraiser is sup-
porting, to effectively answer any questions your members
or others have during the event
EVENT REQUEST FORM
If you are planning on holding a divisional event or just
with another KIWIN’S club, make sure to fill out an Event
Request Form (ERF) if your two or more clubs are NOT from
the same Kiwanis club. The form is attached to the end of
this manual and can be found on the KIWINS.org website.
PRIORITIZE
Get important details figured out first
(ie. Location, day, time, pricing) & final-
ized before moving on to any acces-
sory details (ie. Type of foods, decora-
tion, theme)
LOCATION
Grocery store
MATERIALS
baked goods, table, table cloth, ad-
vertising posters, cash box w/ singles
and quarters, napkins, gloves
TIPS
• Assign board members to bake 1 or 2
goods each
• Have a baking social w/ members
• Call a lot of different stores
• Always ask to speak to the manager
who will be there from 7AM-2PM
• Prepackage goods if you can• Prepackage goods if you can
• Advertise on social
media a lot!smallfundraisers8
LOCATION
School & other schools in your divisionMATERIALS
Food, money envelopes, spare singles & quartersTIPSTIPS
• Set a goal amount for each of your board members to sell
• Advertise on posters beforehand so stu-dents bring money to school
• Sell from a well-known brand• Sell during breaks & lunch
• Never carry too much cash with you at one time
LOCATION
Restaurant (Chipotle, boba places, Yogurtland, Souplanta-
tion, Krispy Kreme)MATERIALS
copies of flyersTIPS
• Advertise online & pass out flyers to entire school & division
• Hold them on days of service events, DCM’s, OTC’s/KTC’s, etc. so members
can go after the event• Make sure there is always a board • Make sure there is always a board
member present the day of to thank supporting members
9
LOCATI
ON
Nearby ice rink
MATER
IALS
cash box w/ spare one’s and five’s
TIPS
•Offer pre-sale at a cheaper price
•Offer pre-sale at a cheaper price
to ensure attendees
• Best to hold between November
thru February
• Book early because they are
popular
• Bring a camera to capture memo
• Bring a camera to capture memo-
ries and falls
• Require filling out a release form
with medical & insurance info in
case of an injury
mediumfundraisers
10
11
LOCATION
School, Fall Rally,
DCON, DCM’s
MATERIALS
cash box with spare cash, merchandise
TIPS
• • sell something unique & profitable
• promote on social media to your
home club, division, & district
• provide pre-order forms to gage
member interest
• have a pre-sale price
• many companies that sell wholesale • many companies that sell wholesale
will have a minimum purchase size
• research different manufacturers
• make sure prices are
reasonable
LOCATION
School (cafeteria or
classroom), house
MATERIALS
projector, white screen/wall, video
game, game console & controllers,
chairs & tables for players & spectatorschairs & tables for players & spectators
TIPS
• choose a popular game to play
• use Google forms/sheets for members
to sign up
• create and distribute rules
• either one long tournament or split the • either one long tournament or split the
tournament up based on brackets
• paper/whiteboard to
show wins/losses
largefundraisers
LOCATION
Gym (school, community rec center, fitness centerMATERIALS
Cash box, copies of agenda, fun games & activi-ties (board, card, video games), pies
TIPS
• plan a packed agenda • charge $ for admission
• punishment fee/pie for if members fall asleep• pie Board Members for a cost
12
13
LOCATION
Beach, park, gymMATERIALS
balls, frisbees, water, referees, megaphone, whistle
TIPS
• • create Google forms/sheets for team sign-ups
• publicize rules• offer a reward
• do a simple sport like frisbee, vol-leyball, basketball
• check up on teams to make sure they are still participating•make it a seasonal sport
• have members fill out safety re-
LOCATION
Auditorium, studio, place with comfy seating & large stageMATERIALS
sound system, mics, tickets/wristbands, entertaining MC’s, variety of good performers
TIPS
• • Plan early & secure performers• ask businesses to sponsor raffles for items or gift cards
• advertise early & often• pre-sale is key to getting people to go
• sell food & drinks• assign board members different aspects to be in charge of
14
1515
Put the check in an envelope. Seal the envelope and mail it with the correct postage.
TO: ATTN: Bruce Hennings, KIWIN’S PTP Donation FROM: _____ High School|Club # Cali-Nev-Ha District Office _____ Division 8360 Red Oak Street #201 1234 Street Name Rancho Cucamonga, CA 91730 City, CA Zip Code
Deposit money into your club bank account, school bookkeeper, or Kiwanis bank account
1
3
2Write a check!Payable to: Cal-Nev-Ha KIWIN’S
Memo: ___ Division, ____ High School | Club #
Solicitation Letter Short & concise emails
when asking to host a
fundraiser at a
business/restaurant.
Have succint subject
lines.
Be sure to include:
• Your name & position
• Your KIWIN’S Club & city
* What the fundraiser pro
ceeds will go to
* Your sponsoring Kiwanis * Your sponsoring Kiwanis
club
16
Examples
Special thanks to:
Brian Wang
Kevin Vu Nguyen
Christine Chau
When requesting
sponsorship from
a business, main-
tain utmost cour-
tesy, humility, and
professionalism.
Send a PDF file
letter asking for
donations.
Keep in mind these
are all real exam-
ples to be refer-
enced, not plagia-
rized. Use them as a
resource, but
please respect the
authors’ original
work.
17
Working withyour School
1818
• Always consult your Principal or Vice Principal for permission at least 2 weeks before to hold the fundraiser if it is at your school• Some schools have restrictions on selling • Some schools have restrictions on selling food during school hours, so make sure to ask your administration about your school’s policies• Make posters to put around the school• Advertise your fundraiser on the morning announcements and in your classes• Maintain constant communication with • Maintain constant communication with your faculty advisor
19
Useful Forms• Kiwanis family giving form - Eliminate donations
• Event Request Form - required for fundraisers with schools /divisions outside your home Kiwanis
• KIWIN’S Medical Release • KIWIN’S Medical Release form
Pay
by
cred
it c
ard
:M
aste
rcar
d Vis
a Am
eric
an E
xpre
ss
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isco
ver
Car
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e
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onth
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ear
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e as
it a
ppea
rs o
n cr
edit
card
Pay
by
chec
k:M
ake
chec
k pa
yabl
e to
the
“Kiw
anis
Int
erna
tiona
l Fou
ndat
ion”
and
in
clud
e “T
he E
limin
ate
Proj
ect”
on
the
mem
o lin
e.
Rec
ogn
itio
n in
form
atio
n:
Reci
pien
t na
me(
s)
Ant
icip
ated
pre
sent
atio
n da
te
Emai
l (re
quired
)Rec
ogni
tion
cert
ifica
te(s
) w
ill b
e em
aile
d to
the
poi
nt o
f co
ntac
t to
be
pers
onal
ized
and
dis
trib
uted
.
Sh
ip a
war
d t
o:
Nam
e
Add
ress
City
Sta
te/P
rovi
nce
Post
al c
ode
Cou
ntry
Phon
e (w
ith a
rea
code
)
Plea
se a
llow
thr
ee w
eeks
for
the
aw
ard
to b
e pr
epar
ed a
nd d
eliv
ered
. If
yo
u ha
ve a
ny q
uest
ions
, co
ntac
t th
e ca
mpa
ign
offic
e at
1-8
00-K
iwan
is,
+1-
317-
217-
6213
or
Cam
paig
n@Th
eElim
inat
ePro
ject
.org
. Re
turn
thi
s co
mpl
eted
for
m v
ia e
mai
l, fa
x (+
1-31
7-47
1-83
23)
or m
ail:
The
Elim
inat
e Pr
ojec
t: C
ampa
ign
Offi
ce36
36 W
oodv
iew
Tra
ceIn
dian
apol
is,
IN 4
6268
USA
U.S
. &
Can
ada:
1-8
00-K
IWAN
IS
Than
k yo
u f
or s
up
por
tin
g T
he
Elim
inat
e P
roje
ct a
nd
for
doi
ng
you
r p
art
to c
han
ge
the
wor
ld!
Do
your
par
t. M
ake
your
mar
k. G
ive
to T
he E
limin
ate
Proj
ect:
Kiw
anis
elim
inat
ing
mat
erna
l and
neo
nata
l tet
anus
.In
div
idu
al r
ecog
nit
ion
Elim
idal
lion:
US$6
25 (
SLP
mem
bers
and
adv
isor
s ar
e el
igib
le)
Reci
pien
t na
me
(req
uire
d)
Clu
b r
ecog
nit
ion
1K C
lub:
US$1
,000
For
per-
mem
ber
aver
age
(sel
ect
only
one
)
Bro
nze
Clu
b: U
S$1
0 pe
r m
embe
rSilv
er C
lub:
US$2
5 pe
r m
embe
rG
old
Clu
b: U
S$5
0 pe
r m
embe
r
Tota
l fun
dsFu
nds
rais
ed t
hrou
gh:
Tric
k-or
-Tre
at for
UN
ICEF
Elim
inat
e W
eek
Sho
w Y
our
Love
, Sav
e a
Life
Oth
er
Clu
b a
ssoc
iate
d w
ith
th
is g
ift:
Clu
b na
me
Clu
b nu
mbe
r
Num
ber
of c
lub
mem
bers
Kiw
anis
-fam
ily p
rogr
am a
ffilia
tion:
K-
Kid
s
Bui
lder
s Clu
b Ke
y Clu
b
CKI
Akt
ion
Clu
b
Prep
arer
nam
e
Emai
l
Phon
e (w
ith a
rea
code
)
Don
or t
o be
cre
dite
d
Giv
e q
uic
kly
and
sec
ure
ly a
t w
ww
.Th
eElim
inat
ePro
ject
.org
/g
ive.
Don
’t f
org
et t
o in
clu
de
you
r K
iwan
is-f
amily
clu
b a
ffilia
tion
wh
en s
ub
mit
tin
g f
un
ds
onlin
e.
GIEP-613-1 (8/13)
The
Elim
inat
e P
roje
ct g
ift
form
for
Kiw
anis
-fam
ily m
emb
ers
For
Ser
vice
Lea
ders
hip
Prog
ram
mem
bers
, cl
ubs
and
advi
sors
/
Page 1 of 4 Approved 03‐05‐10
Event Request Form An Event Request Form (ERF) must be completed and approved before an event can be publicized outside the immediate club membership. Prior to approval, the event may be posted on social or business networks ‐ such as MySpace or Facebook ‐ or promoted by email, only to the home club membership. Once approved, the event may be posted with a closed invitation list. ERFs must be submitted no later than three (3) weeks in advance of the proposed event.
The ERF must be filled out in compliance with Kiwanis District Policy concerning Service Leadership Programs, paragraph 721, which specifically addresses procedures for Service Leadership Programs when operating outside the normal club functions. Further, high school students must adhere to Key Club District Policy section 105.6 if the event is an overnight event. Kiwanis District Policy Section 721 and Key Club District Policy Section 105.6 are included for your reference.
Each participating high school member must also have a Consent and Medical Release form completed and signed by a parent/guardian. To help you determine which events require a completed ERF, please refer to the Information Worksheet on the back side of this form. School/Institution Name: ___________________________________ Circle K Key Club KIWIN’S
EVENT INFORMATION
Event: Date(s):
Location:
Description, including cost:
Which clubs or divisions will be invited?
Is This An Overnight Event? Yes No (Check One)
CONTACT INFORMATION
Requestor:
E‐mail: Telephone:
Address:
City/State/Zip:
Supervising Advisor(s) who will be present throughout the event:
Supervising Advisor’s Telephone Number(s): (Number(s) available during the event)
APPROVAL as necessary by clause, (see Kiwanis Policy Section 721)
Faculty Advisor: Kiwanis/Sponsor Advisor:
Region Advisor: District Administrator:
When completed and signed by your advisor, please return this form to your Event Host.
www.cnhkiwanis.org
SERVICE LEADERSHIP PROGRAMS y 8360 Red Oak Street, Suite 201 y Rancho Cucamonga, CA 91730‐0608 Office: 909‐989‐1500, ext. 105 Toll Free: 877‐597‐1770, ext. 105 Fax: 510‐550‐2811
Kiwanis California-Nevada-Hawaii District
Page 2 of 4 Approved 03‐05‐10
Event Request Form
Information Worksheet for Key Club and KIWIN’S Members Kiwanis District Policy Section 721 covers the use of the Event Request Form (ERF). Key points include:
1. An Event Request Form (ERF) must be completed and approved before an event can be publicized outside the immediate club membership.
2. Prior to approval, the event may be posted on social or business networks ‐ such as MySpace or Facebook ‐ or promoted by email, only to the home club membership. Once approved, the event must be posted with a closed invitation list.
3. ERFs must be submitted no later than three (3) weeks in advance of the proposed event.
If any club or division advertises an event prior to receiving the proper signatures, the event is subject to cancellation by the Faculty Advisor, Kiwanis /Sponsor Advisor, Regional Advisors and/or District Administrator.
EVENT Permission of original faculty
advisor
Permission of all involved clubs’ faculty advisors
Permission of Kiwanis /Sponsor
Advisor
Permission of Regional Advisor(s)
Your Key Club Only Yes N/A Yes No
Within your Division Yes Yes Yes Yes
Outside your Division Yes Yes Yes Permission from all involved R/A’s
Involves other Service Leadership Programs or any Overnight
Event
Yes Yes Yes
Yes, and the District
Administrator
What does “Permission” mean? You must have written authorization (e.g. e‐mail) from the necessary individuals. Which events do not require an ERF? The events that do not require an ERF are the following: Divisional Council Meetings (DCMs), Regional Training Conferences (RTC), KIWIN’S Training Conference (KTC), Fall Rally (North/South), Conclave, District Convention, International Convention or any event where the sponsoring organization invites Key Club members to participate (e.g. Rose Float, Relay for Life). Who shall retain a copy of the completed ERF? Each advisor(s) who signs the ERF should be given a copy of the completed ERF. For example, faculty advisor(s) shall be given a copy of the ERF with the acknowledgment from the sponsoring Kiwanis/organization for individual club events. The sponsoring Kiwanis/organization shall keep a copy of the completed ERF for one year following the date of the event. Why do we have ERF forms? The ERF was developed to avoid any situations where the Faculty, Kiwanis and/or sponsoring Advisors could become unaware of the activities transpiring beyond the local and/or divisional level. The purpose of the ERF is to ensure the advisors are aware of the projects, to answer parental questions, and to ensure proper advisor attendance at events. Furthermore, these forms will also allow students to understand the importance of planning, properly advertising each event (for higher attendance), and allowing the sponsoring organization time to ensure proper supervision at each event. What do we do if we do not have a faculty advisor or when the regular academic term is not in session? The Kiwanis/sponsor advisor representative may sign in place of the faculty advisor when the regular academic term is not in session.
Page 3 of 4 Approved 03‐05‐10
Kiwanis District Policy ‐ Section 721: Procedures for SLP to Operate Outside the Normal Club Functions A. Events organized within the confines of an SLP club are subject to approval or disapproval, by either its faculty or
Kiwanis/sponsor advisors. (03/10)
B. Events within a Division (06/09)
1. Events organized solely for one SLP Organization, solely within an SLP division, require the advance approval of the applicable Regional Advisor and an authorized representative of the Kiwanis/sponsor organization of the host club. (03/10)
2. Events in this category for high school SLP clubs shall require approval on an Event Request Form (ERF).
3. Each high school SLP club that participates is required to obtain the signature of its faculty advisor and Kiwanis/sponsor advisor on the ERF to attend. The host club shall be required to collect the signed ERF(s) and give them to the club’s Kiwanis/sponsor advisor in the event an audit is later required. ERF forms and associated e‐mails shall be retained for one year following the event. The Kiwanis/sponsor advisor representative may sign in place of the faculty advisor when the regular academic term is not in session. (03/10)
C. Events within an SLP Organization (06/09)
1. Events organized solely for one SLP Organization, but to include any other SLP division, require advance approval of the applicable Regional Advisors.
2. Events in this category for high school SLP clubs shall require approval on an ERF.
3. Each high school SLP club that participates is required to obtain the signature of its faculty advisor and Kiwanis/sponsor advisor on the ERF to attend. The sponsoring club shall be required to collect the signed ERF(s) and give them to the host club’s Kiwanis/sponsor advisor in the event an audit is later required. ERF forms and associated e‐mails shall be retained for one year following the event. The Kiwanis/sponsor advisor representative may sign in place of the faculty advisor when the regular academic term is not in session. (03/10)
4. For Circle K clubs, an individual member may participate with a local club other than his or her home club while staying with family, or as the single guest of a member of the host club. This exception shall not be used to avoid the general purposes of this policy.
D. Events involving more than one SLP Organization (03/10)
1. Events organized to include SLP clubs, from any SLP Organization, but limited to the clubs sponsored by the same sponsoring organization, shall require only advance approval from the sponsoring organization. (03/10)
2. Events organized to include SLP clubs from other SLP Organizations will require the permission of the applicable Regional Advisors and District Administrators from all involved SLP Organizations. (03/10)
3. Each high school SLP club that participates is required to obtain the signature of its faculty advisor and Kiwanis/sponsor advisor on the ERF to attend. The host club shall be required to collect the signed ERF(s) and give them to the host club’s sponsor advisor in the event an audit is later required. ERF forms and associated e‐mails shall be retained for one year following the event. The Kiwanis/sponsor advisor representative may sign in place of the faculty advisor when the regular academic term is not in session. (03/10)
4. Each high school SLP member will be required to have a signed consent form, as designated by the applicable District Administrator, that gives permission to attend and for medical treatment, or an express direction to withhold medical treatment based on religious belief.
5. If a Circle K club hosts a “Key to College” or other similar event designed to provide members of both Key Club Districts with an educational program in preparation for college, the event is limited to daylight hours, and the invited Key Clubs and KIWIN’S clubs are within thirty‐five (35) miles of the event location, the event shall not require advance approval from Regional Advisors or District Administrators. However, the Circle K club shall advise the applicable Regional Advisors by email at least one week before invitations are extended to the Key Clubs and KIWIN’S clubs, and any Key Club or KIWIN’S club that attends shall be required to comply with paragraphs D(3) and D(4). (03/10)
E. Process and Responsibilities (06/09)
1. Each District Administrator shall ensure that an email address is posted for each Regional Advisor on the SLP website.
2. ERFs must be submitted no later than three weeks in advance of the proposed event.
Page 4 of 4 Approved 03‐05‐10
3. Regional Advisors are expected to respond within five (5) days. In the event that a Regional Advisor will be unable, for reasons of travel, business or other matters, to reply regularly within that timeframe, he/she shall arrange with the District Administrator for the posting of an alternative approver’s email address.
4. The Director of Service Leadership Programs shall provide a copy of this policy by email to incoming Kiwanis club presidents and secretaries and/or sponsoring organizations through regular District communication channels. Each District Administrator shall include education regarding this policy for the student leaders, advisors and Regional Advisors in their respective SLP Organizations, annually. (03/10)
5. Events may only be advertised by email or posted on social or business network sites in advance of ERF approval if the advertising is limited to the host club members and their advisors. Once ERF approval is obtained, events may only be posted with a closed invitation list. Postings shall specifically identify the hosting club and not be made in the name of the SLP Organization in general.
6. References to high school clubs shall apply to all Key Club (CNH and KIWIN’S) whether school based or community based. (03/10)
7. If a club is discovered to have attended without permission, falsified permission materials or advertised without permission, the Regional Advisor shall notify the organization and may deny permission for individuals or clubs to attend future events as the Regional Advisor deems appropriate based on the severity of the offense. The sponsoring organization may take whatever measures it determines are appropriate, including but not limited to the suspension of participation by individuals or referral for campus discipline. (03/10)
Key Club District Policy ‐ Section 105.6: Overnight Functions a. Any overnight function operated by or advertised as a Key Club sponsored event must be approved in advance by the
Administrator. The organizer of the function shall obtain written authority before the event is publicized. The request shall indicate the date, location and purpose of the event, the responsible adult in charge and the anticipated clubs attending. The District Code of Conduct must be enforced at all events.
b. Attendance at any Kiwanis Family overnight function or overnight travel to attend a function by any Key Club member must be approved in advance by the Regional Advisor, the Administrator or a designated alternate.
c. Extended trips by club members of more than 24 hours outside the home Division (such as interclub tours) must be approved by the Faculty or Kiwanis Advisor in writing.
d. Approval of the sponsor advisor, school advisor, principal or other appropriate school official must also be obtained in advance.
e. Each Key Club member must provide the completed District Medical Release/Approval form before gaining admittance to any overnight event.
Consent to Attendance at KIWIN’S Events and Medical Authorization I am a parent or legal guardian of (my child) and give my consent as follows: 1. for my son/daughter to attend all official functions of the California-Nevada-Hawaii KIWIN’S. 2. my son/daughter to be transported to these events by scheduled commercial transportation or an adult
operated vehicle. 3. any responsible adult who is acting as a chaperone for my child is authorized to obtain any medical and/or
dental treatment for my child which the chaperone in their sole discretion may deem necessary. Any medical doctor, dentist, hospital or other treatment facility is requested to cooperate with the chaperone if they request medical or dental treatment for my child. This medical authorization shall include but shall not necessarily be limited to hospitalization, out patient treatment, the giving of medications, injections, blood transfusions, surgery, x-rays, physical therapy or any other forms of medical or dental treatment whether or not specifically listed herein; provided however, that the adult consenting or authorizing such treatment shall have first attempted to contact me at the telephone number set forth below unless the need for treatment results from emergency situations that require immediate treatment such that a prior attempt to contact me is not practical or reasonable.
My child has the following known allergies or medical conditions: (none) _________________________________ ____________________________________________________________________________________________ My child is taking the following medications: (none) __________________________________________________ ____________________________________________________________________________________________ Medical Insurance Policy Carrier ___________________________________________________________
Policy Number __________________________________________________________
Dated: ___________________________ _________________________________________________ (parent) (legal guardian) _________________________________________________ (emergency phone number)
Thank you for reading
the 2015-2016
Official Fundraising Manual
For further information please contact
KATHY BUIDistrict Treasurer
IRIS SHIMCamarillo President
ASHLEY KIMGlen A. Wilson Treasurer
JUSTIN LIEBTurquoise Divisional Treasurer
CHARISSA NGUYEN
DCON Chair