Woodgate Choir Travel Form

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Email *

Student Name *

Student Class Period *

5th Period Boys

6th Period Girls

7th Period Girls

I hereby give permission for my son/daughter to go on trips with the Woodgate Choir Department during the 2021-2022 school year. I understand all trips will be by school bus under the supervision of Midway Independent School District personnel. I hereby relieve the Midway Independent School District of all responsibility beyond that of normal supervision. Parents will be notified in advance of all choir trips. As parent/guardian of the above named student, I authorize the school to take my child to a doctor for treatment of accident or sickness and to administer first aid as deemed necessary by proper officials of MISD. I assume all responsibility for bills incurred for medical expenses in excess of any insurance coverage on the student. Parents will be notified of any injury as soon as possible. In non-emergency cases, parents will be notified prior to medical treatment by professional. *

Yes

Student Insurance information: Company: *

Policy Number

Group Number

Name on Policy

Student's Physician

Physician's Phone Number

Emergency Contact - Name and Phone Number *

Parents - by typing your full name you are digitally signing this document with your signature. Please type your first and last name below. *

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