Field Trip Permission Form

Dear Parent or Guardian,

Our school has planned a field trip for 6th Grade students to Destination A on 12/12/2023. This field trip is intended to provide our students with a unique and educational experience that cannot be replicated in the classroom.

We ask for your consent for your child to participate in this field trip. Please fill out the following information:

Child's Full Name

First NameLast Name

Class

Destination

I, the parent/guardian of the student named above, agree with the following statements:

I have indicated below any permanent or temporary medical or other condition(s) including special dietary and medication needs, or the need for visual or auditory aids, which should be known about my child: (please write "N/A" if this does not apply to your child)

Emergency Contact Name:

First NameLast Name

Phone Number (1)

Format: (000) 000-0000.

Phone Number (2)

Format: (000) 000-0000.

Additional Contact

First NameLast Name

Phone Number (1)

Format: (000) 000-0000.

Phone Number (2)

Format: (000) 000-0000.

Children must bring a disposable lunch (no glass bottles) labeled with his or her name. If it is a hardship for you or you are unable to provide lunch for your child on the day of the trip, please let us know ASAP so we can arrange to get a bagged lunch from the cafe.

Are you interested in joining us as a chaperone? (We are limited to only a few chaperones per trip so we will confirm with you once we receive responses. Also, please note that chaperones will be responsible for paying all trip fees).

Name of Parent/Guardian

First NameLast Name

Date

Signature of Parent/Guardian