Jungle Island ECB K-5 Field Trip Waiver Form

ECB K-5 Jungle Island Field Trip Waiver Form

Please complete this form to provide consent for participation in the upcoming field trip.
Participant Information
Student Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student
Medical Details
Does the participant have any allergies, illness, or other diseases?
If so, please list them:
List any prescribed medication, if applicable:
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Participant/Parent/Guardian Signature
ATTENTION:
To reserve your child's spot, please submit the $35 field trip payment using the link below. Registration is not complete until payment is received.

Deadline: October 14th,2026

Field Trip Payment Link

Please also fill out the MANDATORY Safety Waiver. Your child will not be allowed on the bus without it:
Should be Empty:

ECB K-5 Jungle Island Field Trip Waiver Form