BF CL5 102 - 7/15

FIELD TRIP PERMISSION FORM

PARENT NAME

CHILD’S NAME

I HEREBY GIVE PERMISSION FOR THIS CHILD TO PARTICIPATE IN THE FOLLOWING ACTIVITY

DESTINATION

DATE

DEPARTURE TIME RETURN TIME

MODE OF TRANSPORTATION

ASSOCIATED COST DUE BY

PLEASE LIST ANY MEDICATIONS YOUR CHILD IS CURRENTLY TAKING

PLEASE LIST ANY ALLERGIES OR SPECIAL NEED RELATED TO YOUR CHILD

Your child may not be dropped off at any field trip and must be at the center for the time of departure and must leave with the class. Please have you child at the center at least 15 minutes before the time of departure. All children must be signed in at school to attend the field trip.

The parent or guardian is reminded that every reasonable precaution will be taken to provide for the care and safety of the children. In the event of an emergency, every effort will be made to notify the parent. If the parent cannot be reached in the event of an accident, emergency or illness, permission is also granted to the teacher and school personnel to authorize any necessary hospitalization, medical treatment and transportation thought to be necessary for the above named child. A copy of this permission form will accompany the student on the field trip. The parent or guardian hereby assumes all financial responsibility for hospitalization, medical treatment and transportation provided.

I understand that all policies, which govern Little Sunbeams, also apply at all times during field trips. I have read the above guidelines and, as the party legally responsible for the above named child, agree to all the statements and terms. Field trips are subject to change due to weather or any other unforeseen circumstances. Every effort will be made to reschedule or substitute a similar field trip.

PARENT/GUARDIAN’S SIGNATURE DATE SIGNED

Little Sunbeams Child Development Center 201 University Blvd NE • Albuquerque, NM 87106

www.LittleSunbeams.org • (505) 244-3900