Parents/Guardians Permission for Students to Leave Campus for School Activities
| * Student name (First, Last, Middle initial): | , |
| Enter the following information for the trip you are providing permission for: | |
| * Location: | |
| * Date leaving school: | at (time) |
| * Date returning to school: | at (time) |
| I understand my child will be traveling by: | Bus Personal vehicle |
| In case of an emergency, please enter contact information: | |
| Note: By submitting this form, you automatically give permission for your child to receive medical treatment. | |
| * Name: | |
| * Phone number: | |
| Should we need to contact you regarding submission of this form, please enter contact information: | |
| * Phone number: | |
| Sign below (by typing your name) to verify that the above information is correct: | |
| Note: Submitting this form by any person other than the legal parent/guardian of a child could result in school disciplinary and/or legal action against that person. | |
| * Signature: | |
| Date of submission: | 11/23/2009, 5:59:44 AM |
Last Updated: 6/22/2009




