School Field Trip Movie Permission Form
Please complete this form to provide permission for your child to participate in the school field trip movie screening. All information will be used solely for trip planning and student safety.
Student Full Name
*
First Name
Last Name
Student Grade
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
School Name
*
Field Trip Destination
*
Field Trip Date
*
-
Month
-
Day
Year
Date
Movie Title Being Screened
*
Movie Rating
*
Please Select
G (General Audiences)
PG (Parental Guidance Suggested)
PG-13 (Parents Strongly Cautioned)
Permission to Watch the Movie
*
Yes, I give permission for my child to watch the selected movie.
No, I do not give permission for my child to watch the selected movie.
Are there any content restrictions or concerns related to the movie screening?
*
No concerns
Yes, I have content restrictions or concerns (please specify below)
If you have content restrictions or concerns, please provide details:
Emergency Contact Name (if different from parent/guardian)
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please list any special instructions, accommodations, or medical needs relevant to your child for this field trip.
Submit Permission Form
Should be Empty: