Algonquin And Lakeshore Catholic District School Board Parent Or Guardian Permission For Out Of School Events Form
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LGONQUIN AND
AKESHORE
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Teacher(s):
Grade(s):
To: Parents and Guardian: The purpose of this form is two-fold:
1. To inform you of the nature of this program
2. To seek your support and permission for your child to participate
Date(s)/Time(s) of Departure from School:
Date(s)/Time(s) of Return to School:
Destination:
Method of Travel:
Financial Arrangements (Total Cost):
$
Educational Purpose:
Physical Description of the Area to be Visited:
(i.e. lake, park, river, etc.)
Activities to be Undertaken:
Note to Parents:
Prior to the school trip, there will be classroom time devoted to establishing safety procedures.
ELEMENTS OF RISK
Educational activity programs, such as sporting events, field trips and other activities, may present various elements of risk. Incidents
related to such activities may occur and cause injury through no fault of the school board or the facility at which the activity or event is being
held. Participants MUST assume these risks. The Algonquin and Lakeshore Catholic District School Board does not provide any
accidental death, disability, dismemberment or medical expenses’ insurance on behalf of students participating in these activities.
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ACKNOWLEDGEMENT
WE HAVE READ AND UNDERSTAND THESE WARNINGS
Date
Signature of Parent/Guardian
Signature of Student ((if 18 yr. old)
Date
Signature of Teacher
Signature of Principal
PERMISSION FORM
Return to School by:
I give (____) do not give (____)
permission to
(Name of Student)
participate in the
to be held at
.
Date
Signature of Parent/Guardian
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