Please allow my student _________________________(student’s name)
to attend the following field trip to:_______________________________
Date of field trip:__________________________________________
Alternate Destination (if applicable):___________________________
Mode of Transportation:________________________________
Cost to Student (if applicable):___________________________
I hereby give permission for my child to participate in the above-mentioned school-related student trip.
In the event of an accident or sudden illness while on the school-related trip, I authorize school personnel to take whatever action is deemed necessary in their judgment for the health of said child including, but not limited to, authorizing medical treatment.
Phone Number where I can be reached:___________________________
Parent/Guardian Signature_____________________________________Date___________
*Note: The reader is encouraged to review policies and/or procedures for related information
Implemented: 01/09/2006 Hillsboro R-III School District, Hillsboro, MO
Sincerely,
The Art Department
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