Genesis City - Field Trip Form

1
Field Trip Event
Please Select
Please Select
Phoenix Zoo 3/30/2026 8:30am - 1:00pm
2
Student Name* This field is required.
First Name
Last Name
3
Parent/Legal Guardian Name* This field is required.
First Name
Last Name
4
Phone Number* This field is required.
Area Code
Phone Number
5
ACTIVITY PERMISSION SLIP* This field is required.
I, the undersigned, being the parent(s)/legal guardian(s) of the above named child, understand that the child will be participating in a class trip under the guidance of personnel of the school. We/I give said child permission to participate in this activity. We/I assume full responsibility for the attendance of said child and we/I hereby agree not to hold [SCHOOL NAME] or its personnel responsible for any and all liabilities arising from any accident as a result of travel to and from and participation in this activity.
6
AUTHORIZATION FOR MEDICAL CARE* This field is required.
We/I, the undersigned, being the parent(s)/legal guardian(s) of the above named child, do hereby authorize nurses, physicians, surgeons, or dentists chosen by personnel of [SCHOOL NAME] to furnish whatever medical or surgical care or management they may reasonably deem necessary for the well-being of said child while the child is attending this school trip.
7
Parent/LegalGuardian sign here for permission:* This field is required.
8
Date* This field is required.
Date
Month
Day
Year
Should be Empty: