Universal Field Trip Permission Form 2020-2021
During the school year your child will have the opportunity to participate in field trips during regular school hours and past the end of the school day. Rather than requesting a permission slip for every field trip, we would like this one general permission slip for the entire school year. This permission slip covers bus and walking trips. You will be notified in advance concerning all bus trips. If you do not wish your child to take a particular bus trip, please notify the school in writing before the trip occurs.  This slip will be kept on file by the classroom teacher.

The student named below has my permission to accompany his/her class on planned bus and walking field trips during the school day and past the end of the school day. I understand that I will be notified in advance concerning all field trips.
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Email *
Student First Name *
Student Last Name *
Student Date of Birth *
MM
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DD
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Grade *
Teacher's Name *
Student Street Address *
Town *
Parent/Guardian Contact Number *
Please provide us with the best phone number where you can be reached during the day.
Student's Doctor Name and Phone Number *
Please provide us with the name and phone number of your child's doctor.
Parent/Guardian Signature *
By entering my name in the box below I give permission for my child to attend field trips for this school year. I, the parent/guardian, authorize the school administrator to direct members of the school staff to assist/supervise my child in taking the medications listed below, and I agree not to hold liable, any member of the school staff or an individual of official capacity who is directed by me and the school administrator to assist my child in taking said medication. I understand that a chaperone, teacher or other responsible adult designated by the principal may carry my child's medication. In the event of an emergency or serious illness, I request that you contact me. You have my permission to obtain any emergency care necessary to ensure my child's well being while on the field trip.
Medical Information/Special Needs *
Check all that apply below.
Required
Medical Information/Special Needs for My Child
If any of the boxes above for allergies, medical conditions, or medication needs were checked, please provide the details below.  If your child needs to receive medication while on the trip, please specify if you will deliver the medication from home or if the teacher should obtain this medication from the school nurse from my child's supply kept in the health office.
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