High School Field Trip Documentary Consent Form
Use this form to collect student details, parent/guardian contact information, and permission for the student to appear in the field trip documentary.
Student and Parent/Guardian Information
Student Full Name
*
First Name
Middle Name
Last Name
Grade Level
*
School Name
*
Parent/Guardian Full Name
*
First Name
Middle Name
Last Name
Relationship to Student
*
Please Select
Parent
Guardian
Stepparent
Grandparent
Other
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Trip and Participant Details
Field Trip Date
*
-
Month
-
Day
Year
Date
Destination / Location
*
Teacher or Trip Organizer Name
*
First Name
Middle Name
Last Name
Class, Club, or Role
*
Will the student attend the full trip?
Yes
No
If attending only part of the trip, please note timing details
Documentary Media Consent and Restrictions
Guardian Consent for Documentary Media
*
I grant permission
I do not grant permission
Restrictions or Conditions for Media Use
Parent/Guardian Acknowledgement
Emergency and Medical Notes for Trip Staff
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical or Accessibility Notes for Trip Staff
Submit Consent
Submit Consent
Should be Empty: