DATE:______________

Permission form for Parents or Guardians of the student listed below, to participate in this school activity.

Activity:____________________________________________________________

Location of Activity:____________________________________________________________

Date of Activity:____________________________________________________________

Time of Activity:____________________________________________________________

COST: $_______________

I authorize <_____>                                                                        I DO NOT authorize <_____>

 

My child __________________________________to participate in the Field Trip activity listed above.

I hereby absolve of all responsibility, the Teacher(s) in charge, the Principal of the School and all other staff,
in the event that an injury or accident occurs due to my child's negligence and of failure to follow instructions.
I also understand that if my child is irresponsible in any way not that he/she will not be permitted to participate
in all future Field Trips.

If my child does not attend the activity, I understand that he/she must stay home on the day.

_____________________________                                                        ______________________________
Teacher in charge of Activity                                                                             Parent's or Guardian's Signature

____________________________
Principal