Field Trip and In-State Travel Permission Form 2021-2022

Field Trip and In-State Travel Permission Form 2024-2025

Keller Independent School District
Trip: 2024-2025 Band Events

Destination: Varies

Trip Date: 2024-2025 School Year

District Sponsor: Brad Allen

Items Required for Trip: Instruments, Uniforms

Cost: N/A

In order for the student to participate in the field trip or in-state travel, parent/legal guardian must complete and sign the form below.
By my signature below, I (parent/guardian name)* , parent of (student name)* certify to the best of my knowledge that the following information and statements are accurate and true:
Student Name*

First NameMiddle InitialLast Name
Student Birth Date *

MonthDayYear
Grade during 2024-2025 school year*

9th Grade (freshman)10th Grade (sophomore)11th Grade (junior)12th Grade (senior)
School Information

Teacher: Brad Allen

School: Fossil Ridge High School

School Address: 4101 Thompson Road, Fort Worth, TX 76244

Phone: 817.744.1700
Parent/Legal Guardian Information
Parent/Legal Guardian Name*

First NameLast Name
Full Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number

Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Full Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Phone Number*

Area CodePhone Number
Medical Information
Doctor Name

First NameLast Name
Doctor Phone Number

Area CodePhone Number
Health Insurance Company
Health Insurance Policyholder's Name
Health Insurance Policy Number
I agree to the following:
In the event that emergency medical treatment becomes necessary for my student while on the trip and I cannot be contacted, I authorize the school to obtain the necessary treatment.

I understand that all students participating in the trip are required to ride in transportation provided by the school. The school district will not be liable for injuries to students riding in vehicles not provided by the school.

I understand that the District's rules and regulations regarding conduct and discipline apply while students are participating in the trip. Also, the student is required to follow any special rules developed for this particular trip. I understand that in order for my student to participate in major trips, he or she must comply with scholarship and eligibility requirements according to UIL guidelines.

I give permission for my child, identified above, to attend and participate in activities in or around water. I fully understand that activities may include swimming pools, water slides, and other physical activities that may put my child at risk of injury or death.

I release the District, its Board of Trustees, staff, and employees from any damages arising from this trip, except to the extent that liability may be imposed under Texas law. The District, its Trustees, employees, and agents may still claim any governmental or professional immunities allowed by law. As parent or guardian, I agree to hold the District, its trustees, employees, and agents harmless from any damages that may result from my student's actions on the trip.

I have read and understood this permission form and I sign it voluntarily and with full knowledge of its significance. I hereby give permission for my student to participate in this trip.
Parent/Legal Guardian Signature*

Clear
Date*

MonthDayYear
Date
Please inform Directors of any other vital information you think they may need to know in the event of an emergency. Thank you.
Should be Empty:

Field Trip and In-State Travel Permission Form 2024-2025