Parent/Guardian Permission Slip for Field Trip and Indemnity Agreement

Homecoming Activities

September 26th - October 3rd
This permission slip encompasses all SJCA homecoming activities. Any questions can be directed towards Mrs. Bralick at kbralick@sjcawi.org.

Transportation is the responsibility of parents and/or students for all before and after-school activities.

All middle school students must be accompanied by an adult at all after-school activities.

DUE BY: Friday, September 18th

Students who do not have a returned permission slip will not be eligible to participate.
NAME OF STUDENT (First and Last Name)
PARENT/GUARDIAN PERMISSION SLIP FOR FIELD TRIP, DIGITAL ACCESS, AND INDEMNITY AGREEMENT
PHONE
Format: (000) 000-0000.
NAME OF PARENT/GUARDIAN
Email
example@example.com
In the event of an emergency, I give permission to transport my child to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.

On field trips that occur during the length of the school day, any prescription medication already provided to the school will be carried and administered by staff.

If you are unable to reach a parent/guardian at the above number, contact:
MEDICAL INFORMATION AND RELEASE:
ALTERNATE CONTACT NAME
PHONE
Format: (000) 000-0000.
PERTINENT MEDICAL CONDITIONS
FIELD TRIP CONSENT AND RELEASE:
In consideration for my child/ward’s participation, I agree to reimburse and indemnify the parish/school for all reasonable legal and court fees incurred by parish/school in defending a lawsuit that I or my child/ward may bring against the parish/school Which relates to the above named activity if the parish/school is found not legally liable by the courts and prevails in the lawsuit. If the parish/school is found legally liable for injuries sustained by child/ward, this paragraph will not apply.

I certify that I have an understanding of this agreement and any risks and hazards associated with the activity described above that my child/ward will be participating in. I further understand that I had the opportunity to fully discuss this agreement with a representative of the parish/school to clarify any concerns or questions about the activity or this agreement that I may have had.
PARENT/GUARDIAN SIGNATURE
DATE

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Homecoming Activities

PARENT/GUARDIAN PERMISSION SLIP FOR FIELD TRIP, DIGITAL ACCESS, AND INDEMNITY AGREEMENT

MEDICAL INFORMATION AND RELEASE:

FIELD TRIP CONSENT AND RELEASE: