610, 613, 614 - Get your movie consent form signed by a parent/guardian. The text of the form is below. If you do not have the form, have your parent write a note stating that you have permission to watch the movie. They must sign and provide their phone number.
Student Name: ______________________________________________ Class: __________
June 12, 2012
Dear Parent,
As one of our
educational activities for the end of the year, I will be showing a movie that
draws on several of the historical events that students have learned about in
Social Studies. This movie dramatizes key concepts and moments surrounding the
creation of the United States. Viewing this movie will enhance your child’s
understanding and retention of these key social studies concepts. Additionally,
Common Core Learning Standards for listening comprehension skills require
students to build their abilities to focus, take notes, and clarify their
understanding of information.
The movie The Patriot will be shown during four
consecutive class periods from Monday, June 18 to Thursday, June 21. Only age
appropriate and historically valuable scenes will be shown; every effort will
be made to ensure that this happens. Please fill out the bottom of this letter
to show your approval for you student to participate in this lesson. Students
who are not permitted to participate will be assigned to another classroom and
be given an assignment to complete.
Sincerely,
Ms. Wholey
6th Grade Social Studies
I.S. 125, Henry Hudson Middle School
__________________________________
cut/tear here _____________________________________
Student Name: ______________________________________________ Class: __________
Parent/Guardian Name: ___________________________________________
Parent/Guardian Phone number:
___________________________________________
Check one:
_______ Yes, my child may participate.
_______ No, my child may not participate.
Parent/Guardian Signature:
___________________________________________
