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.