LaMotte School, District 43

Field Trip Consent Form

 

Your child’s class is participating in an educational trip.  It is the policy of the LaMotte School District to require parental permission before allowing a student to travel with members of his/her class.  If you would like your child to participate, please read and sign this document.

 

I hereby give permission for my child, ____________________________________,
to go with his/her class to ____________________________________________ for a field trip.  The district will provide transportation.  If travel by a private car is required for this event, I understand that my child will ride with ___________________________________________________________

 

________________________________________________________________________________

List Drivers for this Field Trip

 

As a parent or guardian, I understand that the school and the staff will do everything possible to prevent any accidents.  However, I fully understand that some activities on field trips involve inherent risks to students regardless of all feasible safety measures that may be taken by the district.  In consideration of the district’s agreement to allow my child to participate in the referenced field trip, I agree to accept responsibility for any loss, damage, or injury to my child that occurs during my child’s participation in this field trip that is not the result of fraud, willful injury to a person or property, or the willful or negligent violation of a law by a trustee, employee or agent of the LaMotte School District 43.

 

In the event is becomes necessary for the district staff in charge to obtain emergency care for my child, neither he/she nor the school district assumes financial liability for expenses incurred because of an accident, injury, illness and/or unforeseen circumstances.

 

I have been informed the class will leave on ________ at approximately ________ from LaMotte School, District 43, and will return at approximately ____________. 

 

Parent or Guardian: (Print)______________________________________________

 

Signature: ____________________________________ Date: _________________

 

Address: ___________________________________________________________

 

Telephone: __________________________________________________________

                                List all numbers where you can be reached:  Home, Cell, Work, Etc.

 

Does your child have a medical condition that the school should be aware of before allowing your child to participate on a field trip?  Yes ______  No ______

If yes, please state the nature of the medical condition: ____________________________________

 

 

 

In the event that unforeseen circumstances arise creating a need:

·      for you to contact your student

·     for information to be relayed to you about an emergency, change in itinerary, etc.,

 

An information network has been established.  Your contact person is ______________________, and their phone number is ___________________.