Free community service form 23
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Saddleback Valley Unified School District

Community Assistance Permission and Verification Form
Graduation Requirement: Each high school student must complete at least eight hours of community
assistance service prior to May 1 st of his/her senior year. Students will provide their own transportation
while completing this service. The organization must be “non-profit” and student may not receive
payment for these services. For ideas on Community Service opportunities please refer to:
http://www.svusd.k12.ca.us/ and under featured links click on “guidance” then go to Community
Resources tab.
Student Name

Date of Birth
Please print

High School

Grade

Parent: I give my permission for my child to perform the community service described on this form. I
hereby waive, release, and hold harmless the Saddleback Valley Unified School District and its
personnel from any liability in the unlikely event of an injury while performing this service.
Parent Signature

Telephone

Date

Organization N