I (print names) _________________________________, am the legal guardian of
______________________________, and give full permission to him/her to participate in the
Community Service Program offered by TnJPoetry, Inc.   








                         
__________________________________________
Signature                                                


_______________________________
Phone Number


_______________________________
Date
TnJPoetry, Inc's Community Service Program Permission Slip

TnJPoetry, Inc ~ 3089 N. Tracy Blvd, Suite 422 ~ Tracy ~ CA ~ 95376 ~ 209-321-9052