| Student's
Name______________________________ |
| Class taking
trip______________________________ |
| Date of Trip
_________________________________ |
| Trip
Destination_______________________________ |
| I give permission for
_________________________________ to attend the field trip with the
______________________class.
The date of the trip is ___________________________. |
| Parent's Signature
____________________________________________ |
| Medical Information: Please list
any medical information that we need to know for your child's
safety.
|
| Emergency Phone Number to be
reached:____________________________ |
| Doctor's Name and
Number:______________________________________ |