Name of Event:_______________________________________________________

Date(s) of Event:            Departure:_______________ Return:_________________

Destination:__________________________________________________________
 

I desire that my son/daughter be allowed to travel to and from the event listed above and to participate in this event. 
 

___________________________  ___________________________________  _________
Printed Name of Parent/Guardian                                             Signature of Parent or legal Guardian                                              Date  
 

____________________________________________    ______________________________________________________     ______________
Printed Name of Student                                                     Signature of Student (if 18 or more years in age)                                Date

NOTE:  Student Medical / Emergency Information Card must be on file in the school office.