2025-2026 Field Trip Release Form

Educational Talent Search: 2025-2026 Field Trip Release Form

(Printed copies are available upon request)
Student Information
Student's Name*

First NameLast Name
School Attending*
Grade*
Please select one
Date of Birth*

MonthDayYear
Date
Student's Sex:*

MaleFemale
Student Cell Number*
Please enter a valid phone number.
Parent/Guardian's Emergency Contact Information
Parent/Guardian's Emergency Contact's Name:*

First NameLast Name
Emergency Contact's Cell Number*
Please enter a valid phone number.
Emergency Contact's Other Number*
Please enter a valid phone number.

Field Trip/Medical Release Form
Educational Talent Search takes every precaution to prevent accidents. However, Western Texas College, the Educational Talent Search Department, and the staff assume no responsibility and will not accept liability for accidents that may occur.

I, by signing this document, grant permission for the college employees to secure medical services for the student named above if necessary. I understand that I am responsible for any financial bills incurred due to an accident or illness.

Also, students' non-compliance will lead to disciplinary action by school officials, potentially including removal from the Educational Talent Search program
Insurance/Medicaid Information

**If you do not have insurance/Medicaid, please put N/A in each box.

Please complete the following *

	Insurance Name or Medicaid	Insurance or Medicaid Phone Number	Insurance or Medicaid Policy Number	Insurance or Medicaid Group Number
Insurance or Medicaid Information

Subscriber Information: (Person who pays or provides insurance or Medicaid) *

	Subscriber Name	Subscriber/Policy Number
Subscriber Information:

Physician Information:*

	Physician Name	Physician Phone Number
Physician Information:

Please indicate any medical conditions and/or allergies this student may have: *
*If this does not apply to you, please indicate by including N/A.
I Parent/Legal Guardian, consent that The above student, has my permission to go on Educational Talent Search-sponsored trips from September 1, 2025, to August 31, 2026.

Drug / Alcohol Policy

This applies to any school-related activity, function, or event, on or off school premises.
STUDENTS ARE REQUIRED TO FOLLOW THE DISTRICT CODE OF CONDUCT.

NO STUDENT shall possess, use, transmit, or attempt to possess, use, or transmit, or be under the influence of any of the following substances on school premises, during any school term, or off school premises at a school-related activity, function, or event.

STUDENTS ARE NOT ALLOWED TO POSSESS ANY FIREARMS, EXPLOSIVES, OR WEAPONS AT ANY TIME!
- Any controlled substance or dangerous drug defined by law, without regard to amount, including but not limited to marijuana, any narcotic drug, hallucinogen, stimulant, depressant, amphetamine, or barbiturate.
- Alcohol or any other alcoholic beverage.
- Any abusable glue, aerosol paint, or other chemical substance for inhalation.
- Any other intoxicant, mood-changing, mind-altering, or behavior-altering drugs are prohibited under the Texas Controlled Substances Act or the Federal Drug Abuse Prevention and Control Act.
- "USE" means a student has smoked, ingested, imbibed, inhaled, drunk, or otherwise taken internally a prohibited substance recently enough that it is detectable by the student's physical appearance, actions, breath, or speech.
- "UNDER THE INFLUENCE" means students' faculties are noticeably impaired, which is detectable by the student's physical appearance, actions, and speech.
- The transmittal, sale, or attempted sale of what is represented by any of the above-listed substances is also prohibited under this rule.
Please initial you have read*

Update Student Photo:

** Please note this photo needs to be appropriate and of the student only. PLEASE CHOOSE ONE OF THE FOLLOWING WAYS TO UPDATE PHOTO.
1. Take Face Photo of The Student with your camera on phone/computer.
2. Upload a Face Photo of The Student from a file you already have.

This photo is used for directory information only.
Cancelof

*By signing below and submitting this completed form, you acknowledge that you have read and agree to ALL the above rules and conditions.
Signature of Student*

Clear
Date*

MonthDayYear
Date
Signature of Parent/Guardian*

Clear
Date*

MonthDayYear
Date
Welcome Back To TRIO Educational Talent Search!

May this school year be your best one yet,

filled with growth, learning, and fun.
Heading
Should be Empty:

Educational Talent Search: 2025-2026 Field Trip Release Form

Student Information

Parent/Guardian's Emergency Contact Information

Field Trip/Medical Release Form

Insurance/Medicaid Information

Drug / Alcohol Policy

Update Student Photo:

*By signing below and submitting this completed form, you acknowledge that you have read and agree to ALL the above rules and conditions.

Heading