National Take Our Daughters and Sons to Work Day

MIAMI-DADE COUNTY PUBLIC SCHOOLS PARENT PERMISSION FORM -- FIELD TRIP
Field trips are not mandatory. They are designed to enhance curriculum, to encourage student participation in extra-curricular activities, and to serve as community service projects.
SECTION I. IDENTIFYING INFORMATION
SCHOOL*
STUDENT'S NAME*
I.D. NO.*
GRADE*
SECTION II. NOTIFICATION TO PARENT
This trip will be chaperoned by (parent’s name)*
I understand that if I am unable to pay for the cost of this trip, and I want my child to participate, where appropriate, my child will be given an opportunity to raise funds through authorized fund-raising activities, or be given assistance in identifying another funding source. (This provision does not apply to activities not directly related to classroom instruction, e.g., Grad Bash, football games, banquets, etc.)
-The above time schedule and/or personnel may be changed due to unforeseen circumstances.--
PLEASE KEEP THE TOP PORTION FOR YOUR INFORMATION.
RETURN THE BOTTOM PORTION TO THE TEACHER.
SECTION III. PARENT/GUARDIAN'S WRITTEN PERMISSION TO PARTICIPATE IN ACTIVITY
I hereby give permission for my child*
Name of the student
Student I.D. No.*
I have completed the EMERGENCY CONTACT INFORMATION in Section IV (see below).
SIGNATURE OF PARENT/GUARDIAN*

Clear
DATE*

MonthDayYear
Date
SECTION IV. EMERGENCY CONTACT INFORMATION
1. Name of parent/guardian*
2. Parent/Guardian Phone No(s). Home*
Format: (000) 000-0000.
Business
Format: (000) 000-0000.
Cell
Format: (000) 000-0000.
3. In case parent/guardian cannot be reached, please contact:*
Relationship*
Telephone No.*
Format: (000) 000-0000.
4. Please list any insurance policy covering your child
Policy No.
5. Physician's Name
Telephone No.
Format: (000) 000-0000.
5. Only if applicable, complete the following:
a. My child has the following medical problem:
b. My child takes the following medications regularly: (Proper Medical form #2702 is on file at the school)
c. My child has the following allergies:
I AUTHORIZE MEDICAL TREATMENT FOR MY CHILD IN CASE OF ACCIDENT OR ILLNESS WHILE ON THE TRIP.
PARENT/GUARDIAN SIGNATURE*

Clear
DATE*

MonthDayYear
Date
Should be Empty:

MIAMI-DADE COUNTY PUBLIC SCHOOLS PARENT PERMISSION FORM -- FIELD TRIP

SECTION I. IDENTIFYING INFORMATION

SECTION II. NOTIFICATION TO PARENT

SECTION III. PARENT/GUARDIAN'S WRITTEN PERMISSION TO PARTICIPATE IN ACTIVITY

SECTION IV. EMERGENCY CONTACT INFORMATION