Senior Day- Permission Slip
May 1 2024 @ Pinstack Plano, 1:00 p.m. - 3:00 p.m
This form provides my consent and permission for the Einstein School student listed below to participate in the off-campus activity listed above. I understand and agree that I am responsible for student's transportation needs for this event.
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I agree
Einstein Student Name
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First Name
Last Name
Parent Name
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First Name
Last Name
Parent Contact Number
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Please enter a valid phone number.
Family Physician Name
First Name
Last Name
If applicable, provide any medical condition that the school should be made aware of before allowing this student to participate. Also, include any allergies.
If applicable, list any medications the student needs to have available on the field trip (i.e. inhaler).
Check all that apply:
My student will be driving themselves to and from this event
My student will get a ride to and from the event
I will take my student to and from the event
My student will need a ride to the event
As a parent or guardian, I fully understand that some activities on field trips involve inherent risks to students regardless of reasonable safety measures that may be taken by the school. In consideration of the school's agreement to allow my child to participate in the referenced field trip, I assume the risk in my student's participation in the event. I acknowledge that I will not seek to hold the Einstein School, its Directors, Executives, Staff, Teachers, Employees, or any other person assisting the Einstein School with this event liable if any accident, injury, loss of property, or any other circumstance or incident occurs during or as a result of my child's participation in the event. This release of liability includes accident, injury, loss, or damages to the student or to other individuals or property which may result from the student's participation and transportation to and from the event. I have read, understand, and accept all the above statements and accept full responsibility as described. In the event it becomes necessary for school staff to obtain emergency care for my child, I authorize and accept full financial responsibility for Einstein School employees or volunteers in charge of the students to obtain all necessary emergency medical care and authorize any licensed physician and/or medical personnel to render necessary emergency treatment for my child.
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I agree
Submit
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