RETURN TO MAIN SCHOOL FORMS PAGE/REGRESAR A LA PÁGINA PRINCIPAL

FIELD TRIP PERMISSION AND RELEASE FORM

The undersigned parent/guardian of ____________________________ ______/______/______ Student's Name Birth Datehereby grants permission for the above named student to participate in the following field trip; including all organized activities and transportation:

Date: __________________________ Fee (if any): __________________

Trip Description/Location: ________________________________________

Supervising Staff Member: _______________________________________

Approximate time of departure: ____________________________________

Approximate time of return: _______________________________________

Purpose (state expected learning outcomes or recreational): _____________

______________________________________________________________

Transportation will be by ٱ Commercial bus ٱ School Bus

Students must have proof of private insurance or student accident insurance to participate in co-curricular or extra-curricular activities or field trips away from school.

_______________________________________ ________________/______________ Name of Insurance Carrier Policy Number Group Number

In consideration of the advantages of participation in this field trip, the undersigned agrees that the Board of Education of _________________, its agents and employees, and the driver and/or owner of the vehicle used for the field trip shall be released and exempt from any liability for damages for bodily injuries or property damages that may occur during the trip, except to the extent of insurance liability as provided by law.

Date Signed: ______________________

_________________________________ Signature of Parent/Guardian (circle one)