PARADISE INDEPENDENT SCHOOL DISTRICT
FIELD TRIP
-- PARENT CONSENT FORM


Student_________________________________________ ††††††††††† Grade__________
Teacher ________________________________________ ††††††††††† Date ___________
A
group field trip has been scheduled as follows:
Group or Class ________________________________________________________
Destination ___________________________________________________________
Telephone ___________________ †† Transportation††††††††††
______ School Bus†† _____ Other
We will leave school at ____________ a.m./p.m. and return at ___________ a.m./p.m.
The cost per child is $
_____________ for__________________________________________
in order for your child to participate iní the field trip, you must complete the permission slip below and return it to the school by
******************************************************************************

My child ___________________________ has my permission to go on-the field trip. In the event of a medical emergency ____________________________ has my permission to seek and authorize medical treatment for __________________________. Our family physician is _______________________________ who can be reached at ______________________ and has access to our medical history.
My child has the following allergies: __________________________________________________________________
has received the following inoculations: ________________________________________________________________
and is taking the medication as listed below: _____________________________________________________________

________________________________††††††††††††††† ____________________________
(Parent Signature) ††††††††††††††††††††††††††††††††††††††††††††††††††††††† (Home Telephone Number)

________________________________††††††††††††† ____________________________
(Relationship) †††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† (Work Telephone Number)
In case of an emergency and parent(s) cannot be contacted, please list alternate contacts,

Name _________________________Relationship __________________________________________†††††††††††††††††††††††††††††††††††††† Phone __________________________________ ††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††††††††††††††††††††††††††††††††††††

Name _________________________Relationship __________________________________________†††††††††††††††††††††††††††††††††††††† Phone _________________________________