WE, THE PARENTS OF _______________________________ ALLOW OUR CHILD TO ATTEND
A FIELDTRIP TO McWane ON NOVEMBER 30TH FOR SECOND BLOCK AND FOR THIRD
BLOCK and OCTOBER 21ST FOR 1ST TO LANARK IN THE EVENT OF AN ACCIDENT, WE DO
NOT HOLD PRATTVILLE HIGH SCHOOL, THE FACULTY / SPONSORS / DRIVERS, OR AUTAUGA
COUNTY BOARD OF EDUCATION LIABLE. WE AGREE TO PROVIDE A MEDICAL HISTORY
INCLUDING OUR CHILDS’S DOCTOR’S NAME AND A COPY OF AN INSURANCE CARD. THE
BUS WILL LEAVE AT 7:30 A.M. THE DAY OF THE TRIP. IN THE EVENT THAT MY CHILD
IS LEFT BEHIND, I UNDERSTAND THAT MY CHILD CAN NOT DRIVE TO LANARK OR MCWANE
OR UAB.
_____________________ OR _________________
MOTHER FATHER
LIST OF ANY MEDICAL PROBLEMS:
1.
2.
PLEASE LIST TWO EMERGENCY NUMBER WHERE YOU CAN BE REACHED
NAME TELEPHONE NUMBER
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***ANY EXTRA MONEY LEFT IN THE ACCOUNT WILL BE USED TO PURCHASE HANDS ON
ACTIVITIES ****
