JACKSON Youth Program Permission Slip Form

Jackson Youth Program

Field Trip Permission Slip

I blanks , the parent/guardian of blank give permission for my child to attend Boda Borg - Malden 11/22.

I give permission for my child to ride in any vehicle designated by JACKSON Youth Program, its employees and adult volunteers, while participating in and traveling to and from this event. I also give permission for my child to utilize public transportation while accompanied by JACKSON Youth Program staff while participating in and traveling to and from this event.

I agree to accept full responsibility, financially or otherwise, for any damage my child may do to the property of JACKSON Youth Program, properties visited on outing, other’s personal property, or vehicles used for transportation.

I agree and consent to all of the above stated.

Parent/Guardian Signature

Date

Emergency Contact: Name and Phone Number for the Day of the Trip