General Field Trip Permission Form I Give My Permission For My Child printable pdf download

General Field Trip Permission Form

I give my permission for my child/ward___________________________to attend all Benton Hall

Academy sponsored events and field trips during the course of the 2012-2013 School year.

I hereby give my complete and explicit permission for the child identified above to attend ALL

events and field trips, even in the instance where a specific field trip permission form has NOT

been returned to Benton Hall Academy with my signature.

I understand that Benton Hall Academy will not be held liable for any bodily injury incurred during

any field trip, event or other Benton Hall Academy activity and hereby indemnify and relieve them

of any such liability. I authorize Benton Hall Academy staff (paid or volunteer) to take any

reasonable action designed to help ensure the safety, health and welfare of my child/ward, and

absolve the staff of any liability relating to such actions.

Medical Authorization Form

I hereby authorize the Staff of Benton Hall Academy (paid or volunteer) to take any reasonable

action to obtain emergency medical care for the identified child, and absolve them of any liability

for such action. I hereby authorize any emergency medical, surgical, diagnostic and hospital care,

treatment, or procedures deemed immediately necessary or advisable by emergency medical

technicians, a physician, or a hospital to safeguard my child/ward’s health when I cannot be easily

contacted.

My child has the following allergies, dietary restrictions, or medical conditions:

______________________________________________________________________________

_____

Medications:___________________________________________________________________

_______

In case of emergency, I can be reached at (___) _____-______ or (___) ___-____

If unable to reach me, please contact:

Name:_______________________________ Relationship:_________________________

Phone (___) ___-____

I understand and agree that I may revoke this General Permission and Medical Authorization at

anytime by delivering a written revocation to the Office Manager.

Parent/Guardian Signature_______________________________________________________

Date:____/____/____

General Field Trip Permission Form I Give My Permission For My Child