FORT LEBOEUF SCHOOL DISTRICT PARENT FIELD TRIP PERMISSION/CONSENT FORM WAIVER OF LIABILITY
Stampede of Sound Marching Band - 2024 Season
Student Name
First Name
Last Name
By signing this form, you are permitting your student to attend all Marching Band after school and travel related events.
I hereby certify that I have read this form in its entirety and request that my child participate in the field trip described above. My signature below indicates that I release the Fort LeBoeuf School District, Fort LeBoeuf School District Board of Directors, and its agents from all liability and waive any and all actions, claims, and demands arising from this activity now or at any future time. Furthermore, I understand as the parent or legal guardian that I remain fully responsible for any legal responsibilities which may result from any personal actions taken by the named student.
Name of Parent or Guardian
Signature of Parent or Guardian
Today's Date
-
Month
-
Day
Year
Date
All phone numbers listed below may be used for contact in an emergency situation - please list numbers where you can be reached easily should the need arise.
This includes Parent / Guardian AND both Emergency Contacts.
Parent / Guardian Cell Phone Number
Please enter a valid phone number.
Parent / Guardian Email Address
Please enter your preferred email address
Emergency Contact #1 - Name / Relationship to Student
Emergency Contact #1 - Phone Number
Please enter a valid phone number.
Emergency Contact #2 - Name / Relationship to Student
Emergency Contact #2 - Phone Number
Please enter a valid phone number.
Does your student have any medical concerns we should be aware of?
I give permission to share medical concerns with Marching Band Staff Members:
YES
NO
Does your child take medication they will need to travel with?
YES
NO
Thank You!
Mr. Tatar and Mrs. Strimel
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