Childcare Field Trip Checklist Form
Use this form to provide the key child, trip, emergency, and checklist details needed for a childcare field trip.
Child Information
Child’s Full Name
*
First Name
Middle Name
Last Name
Child’s Age
Classroom / Group
Trip Logistics
Field Trip Destination
*
Trip Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Departure Time
*
Hour Minutes
AM
PM
AM/PM Option
Return Time
*
Hour Minutes
AM
PM
AM/PM Option
Emergency and Pickup Details
Parent/Guardian Name
*
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Allergy or Medical Notes
Checklist Confirmation
Required items for the trip are packed
*
Packed lunch
Water bottle
Extra clothing
No special items needed
Parent/guardian acknowledgement
*
I confirm the information provided is accurate and my child is prepared for the trip
Submit
Should be Empty: