Field Trip Waiver Form

Field Trip Waiver Form
Please complete this form to provide consent for participation in the upcoming field trip.
Participant Information
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth
MonthDayYear
Date
Emergency Contact Information
Emergency Contact Name
First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Participant
Medical Details
Does the participant have any allergies, illness, or other diseases?
If so, please list them:
List any prescribed medication, if applicable:
I, the undersigned, consent to participate in the field trip to ABCD on May 6, 2024, or, if signing as a parent/legal guardian, I give my consent for my child/ward to participate. I understand that the organizers will take all reasonable precautions to ensure the safety of all participants during this trip. In the event of an emergency, I authorize the organizers to seek medical treatment for myself or my child/ward, as applicable, if necessary.
Date
MonthDayYear
Date
Participant/Parent/Guardian Signature
Clear
Should be Empty:

Participant Information