6153 Form Ii - Field Trip Permission - Newington High School printable pdf download

6153 Form II

NEWINGTON PUBLIC SCHOOLS Newington, Connecticut

FIELD TRIP NOTIFICATION/PERMISSION SLIP

Dear Parent/Guardian:

Our class has planned a field trip to __________________________ on ____________________

(location)

(date)

We plan to leave school at _____________________ and return approximately ______________ using

_________________________ transportation. The cost per student is $_______________.

Please return the lower portion of this permission slip and money to me by _________________.

(date)

Checks should be made payable to the ___________________________ School Activity Fund. The

educational purpose of this trip is as

follows:______________________________________________________________________________

At times events require the postponement or cancellation of field trip experiences planned for students. In some instances a

refund is not possible. When a field trip is cancelled, all funds refunded to the school will be returned to the parents or

guardians. It is not possible to provide reimbursement in the event a refund is not provided to the school for the field trip. It is

important for all to understand this refund policy prior to agreeing to participate in a field trip experience.

Please keep the top portion of this permission slip for future reference. If the field trip is postponed, you

will be notified concerning new arrangements. The permission form must be signed and returned in order

for your child to participate. Thank you for your assistance.

___________________________________

(Teacher)

(CUT ON THIS LINE AND RETURN LOWER PORTION TO SCHOOL)

-------------------------------------------------------------------------------------------------------------------------------

FIELD TRIP PERMISSION FORM

_______________________________ has my permission to go on a field trip to _____________ _______

(Student’s name)

on ______________________. Please sign this form granting permission and acknowledging

departure/return times.

1. Does your child have any allergies and/or other health problems? ____no ____yes

If yes, please explain ____________________________________________________________

2. Is your child currently taking any medication? ____no ____yes

If yes, please explain ____________________________________________________________

This form must be returned to the school in order for your child to participate in this field trip.

I wish to be a chaperone for this trip [ ] Yes [ ] No

_____________________________________

____________________

(Signature of Parent/Guardian)

(Date)

6153 Form Ii - Field Trip Permission - Newington High School