Fillable Field Trip Permission Form printable pdf download

NORTH EAST ISD

FIELD TRIP PERMISSION FORM

Field Trip Information

Purpose:

Destination:

Date/Time of Departure:

Date/Time of Return:

Mode of Transportation:

Meal Arrangements:

Money Needed:

Other:

School Name & Phone #:

Teacher Name:

School Principal Signature:

Parents – Keep Top Portion for Your Records

Return Bottom Portion to School

__________________________________________ has my permission to go on a field trip to

(Student Name)

______________________________________________on______________________

(Destination)

(Date)

The undersigned Parent/Guardian (hereinafter, “I”) understands that one or more teachers/chaperones will accompany the

students on the field trip, and that normal precautions will be taken in their interest for safety and well-being.

School districts are immune from liability except when property damage, personal injury or death is caused by a district

employee’s negligent operation of a motor vehicle while performing district duties. As a result, and as a general rule, the

District cannot pay for medical treatment for injuries resulting from activities not directly caused by a district employee’s use

of a motor vehicle. In case of emergency, I give my approval and authorization for first-aid treatment and any medical

treatment of the student named above (the “Student”) by local physicians and/or hospitals, including surgical procedures. I

agree to accept responsibility for payment of all charges incurred during medical treatment.

I hereby agree to release North East Independent School District and its trustees, employees, volunteers, and sponsors

(collectively, the “Indemnitees”), and to indemnify and hold the Indemnitees harmless from, all claims, liabilities, and

expenses, (including (a) claims made by the student named above after reaching the age of majority, and (b) claims for

damages caused in whole or in part by the negligence of the Indemnitees) relating in any way to the student’s participation in

the field trip identified herein.

This form must be signed and returned to the sponsor, teacher or administrator in charge of this group on

_______________________. No student will be permitted to go on this trip who has not completed this form and returned it

to the proper school personnel or who has altered the form in any way

____________________________________________

_____________________________________

Signature of Parent/Guardian

Printed Name of Parent/Guardian

In case of emergency school district staff should contact:

____________________________

_____________________________

_______________________

Name

Relationship to Student

Phone Number

____________________________

_____________________________

_______________________

Name

Relationship to Student

Phone Number

Updated: November 2004 (Forms dated earlier than this should be discarded)

Field Trip Permission Form

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