School Permission Slip Template

School Permission Slip Form
Date: 8/6/2026 Time: 11:50 AM
Location: Regal Essex Crossing
129 Delancey Street, New York NY 10002

Transportation: walking
Student Name
First NameLast Name
Grade/Class
Parent/Guardian Name
First NameLast Name
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name
First NameLast Name
Emergency Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
I, {parentguardianName}, give my permission for my child, {studentName}, to participate in the above-mentioned activity. I understand that my child will be under the supervision of school staff during the activity and that all reasonable precautions will be taken to ensure their safety. I also acknowledge that there may be some risks associated with this activity, and I accept these risks on behalf of my child.
In the event of an emergency, I authorize school staff to seek medical attention for my child and release them from any liability for any injury or illness that may result from the activity.
I understand that my child is expected to follow all school rules and regulations during the activity, and failure to do so may result in disciplinary action.
Date
MonthDayYear
Date
Signature
Should be Empty:

Date:	8/6/2026	Time:	11:50 AM
Location:	Regal Essex Crossing 129 Delancey Street, New York NY 10002

Transportation:	walking

School Permission Slip Form