Douglas County School District
Field Trip Permission Form
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Email *
Teacher's Name:
Clear selection
Parent/Guardian of: (student's first name):
Parent/Guardian of: (student's last name):
Trip to: Keystone Science School
Voyage to Keystone Science School on February 24-26.
Field Trip Permission Form
Because this activity will take place away from your child's school, there are some special considerations and procedures which apply. We have outlined these below:

Your child's participation in this special activity is voluntary. Your written consent at the bottom of this form is necessary for your child to participate.

Participation in activities away from school may potentially involve risks and responsibilities for you and your child that are beyond the scope of those normally associated with traditional school functions under our supervision. These may include, for example, personal injury or damage to personal property. We encourage you to inquire in advance concerning the nature and details of each field trip and of any potential risks which will be assumed through participation. By signing below, you acknowledge that you have made yourself aware of any potential risk associated with the field trip and that you voluntarily and knowingly assume such risk.

The School District's responsibility for injuries to students, or damage to their property in connection with these activities is defined by Colorado law.


The School District does not have any medical/dental/hospitalization insurance covering students for injuries incurred at school or while on field trips.  If you have not already done so you should investigate and must obtain medical insurance coverage for your child.  

If your child fails to abide by District rules of conduct and teacher instructions during the trip, it may become necessary to discontinue his/her participation in the activity.  In that case, you may be responsible for picking up your child immediately.

I hereby give my permission for my student to attend the above-referenced field-trip.  I give permission for my child to be transported to and from the trip destination via district authorized vehicles, including vehicles operated by district-approved charter companies.   I hereby release and hold harmless the District, it’s director, Board Members, officers, agents, employees, teachers and authorized volunteers from any and all liability, liens, claims, demands, actions or cases of action, whatsoever arising from my student’s participation in the above reference field trip.  

By typing my name below, I agree to the above statements.




Parent/Guardian First Name:
Parent/Guardian Last Name:
Medical Emergency/Consent for Field Trip
I,

Parent/Guardian First Name and Last Name:
being the parent or legal guardian of
Student's First Name: *
Student's Last Name:
give my consent for emergency medical and surgical treatment in a licensed medical facility by a licensed physician should my child's condition require it in my absence. I understand that in such a case, reasonable attempts would first be made to contact me, time and conditions permitting.

I confirm to the Douglas County School District that my child is in good health and that his/her participation does not pose a hazard to his/her health or that of participating students.

As long as the medical or surgical treatment considered necessary in the situation is in accordance with generally accepted standards of medical practice for the particular type of injury or illness involved, I impose no specific prohibitions regarding treatment unless stated here:


My student  has the following medical condition(s), which may require emergency care (including allergies):

By typing my name below, I agree to the above statements.
Parent/Guardian First and Last Name: *
Date: *
Emergency Contacts for Day(s) of Field Trip
Parent/Guardian  First and Last Name:
Cell Number:
(For emergency contact during day)
Parent/Guardian First and Last Name;
Cell Number:
A copy of your responses will be emailed to the address you provided.
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