Portage Island Wetlands Field Trip
Eamonn Collins Class with Natural Resources Permission Slip
FOR MORE INFORMATION AND QUESTIONS:
Eamonn Collins
360.758.4431
Student's Name (First M.I., Last)
*
Teacher's Name
*
Grade
*
Parent/Guardian Name
*
Address
*
City, State, Zip Code
*
Phone Number
*
I give permission for my child to attend this field trip.
*
Yes
No
PARENT/GUARDIAN SIGNATURE
*
My Student has a health condition/medical condition (If "None" put "N/A"):
*
Parent Initial
*
Date
*
-
Month
-
Day
Year
Date
Emergency Contact Information:
Name:
*
Phone:
*
Submit
Should be Empty: