Guilford County Field Trip Information/permission Slip Form printable pdf download

GUILFORD COUNTY FIELD TRIP INFORMATION/PERMISSION SLIP

SCHOOL: _________________________________________

A field trip has been planned that will serve as an enrichment experience for those students participating.

The trip will serve as a preparatory/follow-up activity to enrich a regularly scheduled part of the

instructional program. Students will not be allowed to make the trip unless parental permission is granted.

The school system is responsible for students based on the laws of the state of North Carolina. In the

event that an accident happens, medical assistance should be sought immediately. The parent will be

contacted, and medical charges will be assigned to the parent or guardian.

The behavior of our students as it relates to a field trip is of critical importance. Students are always

expected to be on their best behavior. Regrettably, inappropriate behavior can result in disciplinary action,

including in extreme cases being returned home separately at the parent's expense.

The following details are provided for your information:

DESTINATION: ________________________________________________________________

SUPERVISING TEACHERS: ______________________________________________________

DEPARTURE DATE: ______________________________________TIME: _________

RETURN TO SCHOOL: ____________________________________TIME: _________

METHOD OF TRANSPORTATION: ______________________

OTHER: _____________

OTHER MONIES NEEDED: ______________________________________ADMISSION, ETC.)

ARRANGEMENT FOR MEALS: ________________________________________

PARENTS: Please retain the top part of this form for your reference and information. (Complete the

information below, cut along the dotted line, and return the bottom of this sheet to the school

by______________________________.)

(Date)

…………………………………………………………………………………………………………………………………………

PARENTAL FIELD TRIP CONSENT FORM

Destination:

Teacher: ______________________________

I hereby certify that (

)

student's name

__________________________________________ has permission to participate in the field

trip according to the policies and provisions as stated above. In the event of an accident or

medical emergency, I authorize the supervising teachers to seek medical assistance, and I will

assume responsibility for all expenses.

I authorize the following regarding medications. Initial those applicable:

____ none to be taken.

____ authorized per existing “Authorization of Medication for a Student at School” form.

____ authorized per the attached special authorization form (submit the “Authorization of

Medication … “ form found at Procedure JGCD-P to include medicines beyond the

normal school day during this trip).

Parent Signature: _________________________________

Phone Number:__________

Address: ________________________________

Date of Student's Birth: ____________

Doctor's Name: ______________________________ Phone Number: ____________

Name of Insurance Company: __________________________

Policy Number: ______________

If parent cannot be located in the event of an emergency, contact:

Name: ____________________________________________

Phone Number: ______________

Address: __________________________________________Date: _____________

Guilford County Field Trip Information/permission Slip Form

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