Release of Liability Form For Carpooling

Parent Permission Form For Field Trip
Contact Information
Student's Name

First NameLast Name
Parent's Name

First NameLast Name
Address

Street Address

Street Address Line 2

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Phone Number
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Field Trip
Departure Date and Time: 9:00 AM on Friday, March 28, 2025

Return Date and Time: 2:00 PM on Friday, March 28, 2025

Location: "Art of the Brick" event at 524 Rhode Island Ave NE, Washington, DC 20002

Activities: Visual/spatial art integration.

Notes:

* Please bring a fully disposable lunch with full water bottle.

* Please wear school uniforms.

If you choose not to give your permission, please do not bring your child to The King's Chapel on March 28, 2025.
Medical Information
Child's Physician

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Phone Number
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Alternative Emergency Contact

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Phone Number
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Parent's Signature

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Date Signed

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Date
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