Today’s Date: __________________________ Date of Field Trip: _________________________

Time Departing School: __________________ Time Returning to School: ___________________

Field Trip Destination: _________________________________________________________________

Lunch Plans (if necessary):_____________________________________________________________

Cost of Field Trip: ____________________________________________________________________

Other Special Information: ______________________________________________________________

Please sign and return this note no later than ______________________________________________.

The permission slip, with any money due, should be placed in an envelope marked with your child’s name, class, and “field trip.”

If you have indicated that you will drive, your Field Trip Liability Form must be on file in the school office. Each child MUST wear a seat belt while being transported to and from the field trip destination as stated in the Diocesan Handbook. One child to a seat belt. Drivers do NOT have permission to make any side trips during the field trip.

I request my son/daughter, ___________________________________, be allowed to be a passenger in another person’s car or ride a bus(as arranged by the school), for the purpose of going to and from_________________________________________________on___________________________.

I understand all passengers in private vehicles will wear seat belts. By my signature, I agree to hold harmless of neglect any adult chaperone, any staff member, the school, parish, or diocese in case an accident occurs while on this trip.

Parent/Guardian__________________________________________Date________________

Home Phone______________________ Work Phone_______________________________

_____I will be able to drive for this field trip. I have _____ number of seat belts.

_____I will not be able to drive for this field trip.

**The preferred method of payment for Field Trips is cash or check made out to the teacher, because the teachers pay for the field trip upon arrival at the destination.