Field Trip
Field Trip Permission Form
Your child’s class will be attending a field trip to:
Location:
Date:
Time:
Cost: (Exact amount in cash in a sealed envelope marked with the
words, __________________, and your child’s name)
Lunch: A bag lunch and a beverage (A bag lunch means that the students bring
their lunches to school in their regular lunch boxes.
Teacher(s): Mrs. Kavanagh and Mr. Kedzielawa
Please return this permission slip by ________
I give permission for my child,
______________________________________________,
to attend the field trip to____________________
on____________________________________________.
If there are any recent health problems of which we are nor aware,
please note:
______________________________________________________________
______________________________________________________________
In case of an emergency, I give permission to receive medial treatment. In
case of such an emergency, please contact:
______________________________________________, ________________________
(name: please print) (phone number)
______________________________________________, ________________________
(parent/guardian (date)
______, Yes, if called upon I am available to chaperon this trip.
______, No, if called upon, I am unavailable to chaperon this
trip.