FIELD TRIP PERMISSION FORM

SCHOOL/ORGANIZATION INFORMATION

[ORGANIZATION NAME]

Address: [ADDRESS]
Phone: [PHONE]
Email: [EMAIL]

TRIP INFORMATION

TRIP DETAILS

Purpose of Trip

[DESCRIBE THE EDUCATIONAL PURPOSE AND ACTIVITIES]

Transportation

☐ School Bus
☐ Charter Bus
☐ School Vehicles
☐ Public Transportation
☐ Walking
☐ Parent Volunteer Drivers
☐ Other: [SPECIFY]

Meals

☐ Students should bring a packed lunch
☐ Lunch provided by school/organization (Cost: $[AMOUNT])
☐ Lunch provided at destination
☐ Students may bring money for food: $[AMOUNT] recommended
☐ Other: [SPECIFY]

Cost

☐ No cost to students
☐ Cost per student: $[AMOUNT] (Due by: [DATE])
☐ Financial assistance available upon request

Dress Code/Special Requirements

☐ Regular school attire
☐ Comfortable walking shoes required
☐ Weather-appropriate clothing (layers recommended)
☐ Specific dress requirements: [SPECIFY]
☐ Items to bring: [SPECIFY]
☐ Items NOT to bring: [SPECIFY - e.g., electronics, valuables]

STUDENT INFORMATION

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACTS

Please provide contacts who can be reached during the trip:

MEDICAL INFORMATION

Health Conditions

Does your child have any of the following?

☐ Allergies (food, medication, environmental): _________________________________

☐ Asthma: ☐ Mild ☐ Moderate ☐ Severe
Triggers: _________________________________

☐ Diabetes: ☐ Type 1 ☐ Type 2

☐ Seizure Disorder: _________________________________

☐ Heart Condition: _________________________________

☐ Motion Sickness

☐ Other Medical Conditions: _________________________________

Medications

Will your child need medication during the trip?

☐ No medications needed

☐ Yes - please list:

Medication Administration:
☐ Student may self-administer medication(s)
☐ Staff should administer medication(s)
☐ Medication attached with proper authorization form

Note: All medications must be in original containers with pharmacy labels. A separate Medication Authorization Form may be required.

Physical Limitations

☐ My child has no physical limitations

☐ My child has the following limitations: _________________________________

Accommodations needed: _________________________________

Medical Insurance

DIETARY NEEDS

☐ No dietary restrictions

☐ Food allergies: _________________________________

☐ Vegetarian ☐ Vegan ☐ Kosher ☐ Halal

☐ Other dietary needs: _________________________________

PERMISSIONS AND AUTHORIZATIONS

Field Trip Permission

☐ I give permission for my child, [STUDENT NAME], to participate in the field trip described above.

☐ I give permission for my child to travel via the transportation method(s) indicated.

Walking Permission (if applicable)

☐ I give permission for my child to walk between locations during this field trip under staff supervision.

Water Activity Permission (if applicable)

☐ I give permission for my child to participate in water activities during this field trip.
☐ My child can swim: ☐ Yes ☐ No ☐ Beginner

Photo/Video Permission

☐ I give permission for my child to be photographed/videotaped during this field trip for school/organizational use.
☐ I do NOT give permission for my child to be photographed/videotaped.

MEDICAL AUTHORIZATION

Emergency Medical Treatment

In the event of illness or injury during this field trip:

☐ I authorize school/organization staff to seek emergency medical treatment for my child if I cannot be reached
☐ I authorize emergency medical technicians and physicians to provide necessary treatment
☐ I authorize the administration of basic first aid for minor injuries
☐ I agree to be responsible for all medical costs incurred

Treatment Preferences (Optional)

☐ Preferred hospital: [HOSPITAL NAME]
☐ Religious or other considerations: _________________________________

Parent/Guardian Initials: _______ Date: _______

BEHAVIOR EXPECTATIONS

Student Agreement

Students participating in this field trip are expected to:

☐ Follow all school rules and code of conduct
☐ Obey all chaperone and staff instructions
☐ Stay with assigned group at all times
☐ Treat all property with respect
☐ Represent the school/organization positively
☐ Not possess or use prohibited items (weapons, drugs, alcohol, tobacco)
☐ Electronic device policy: [SPECIFY]

Consequences

☐ I understand that violations of behavior expectations may result in:
- Immediate parent contact
- Exclusion from trip activities
- Early parent pick-up at parent's expense
- School disciplinary action upon return
- Exclusion from future field trips

ASSUMPTION OF RISK AND RELEASE

Acknowledgment of Risks

I understand and acknowledge that:

☐ Field trips and off-campus activities involve inherent risks
☐ These risks include but are not limited to: travel accidents, injuries during activities, exposure to weather, illness, and unforeseen hazards
☐ [ORGANIZATION NAME] takes reasonable precautions but cannot guarantee a risk-free experience
☐ I have voluntarily chosen to allow my child to participate

Release of Liability

I, the undersigned parent/guardian, hereby release [ORGANIZATION NAME], its board, administrators, teachers, employees, volunteers, and chaperones from any and all liability, claims, demands, and causes of action arising out of or related to my child's participation in this field trip, except for claims arising from gross negligence or willful misconduct.

Indemnification

I agree to indemnify and hold harmless [ORGANIZATION NAME] from any claims arising from my child's conduct during this field trip.

CHAPERONE INFORMATION (If Parent/Guardian Volunteering)

☐ I am available to chaperone this field trip

☐ I have completed a background check (if required)
☐ I will attend the chaperone meeting on [DATE]

SPECIAL NOTES OR CONCERNS

Please note any additional information we should know about your child:

_________________________________
_________________________________
_________________________________

REQUIRED ACKNOWLEDGMENTS

By signing below, I certify that:

☐ I have read and understand all information about this field trip
☐ I grant permission for my child to participate
☐ I have provided accurate medical and emergency contact information
☐ I understand the behavior expectations
☐ I authorize emergency medical treatment if needed
☐ I have read and agree to the liability release

SIGNATURES

Parent/Guardian Consent

Signature: _________________________________ Date: _____________

Printed Name: _________________________________

Relationship to Student: _________________________________

Daytime Phone: _________________________________

Student Agreement (Recommended for Grades 4+)

I have read the behavior expectations and agree to follow all rules during this field trip.

Student Signature: _________________________________ Date: _____________

Student Printed Name: _________________________________

PAYMENT (If Applicable)

☐ Payment of $[AMOUNT] enclosed
☐ Check #: ____________
☐ Cash
☐ Online payment completed on [DATE]
☐ Financial assistance requested

RETURN INSTRUCTIONS

Please return this completed form by: [DUE DATE]

Return to: [TEACHER/OFFICE NAME]

Location: [DROP-OFF LOCATION]

Students without a signed permission form will not be permitted to attend the field trip.

FOR OFFICE USE ONLY

ALTERNATIVE: BLANKET FIELD TRIP PERMISSION

For multiple trips throughout the year:

ANNUAL FIELD TRIP PERMISSION

[SCHOOL YEAR]

I give permission for my child, [STUDENT NAME], to participate in local walking field trips and school-sponsored educational excursions throughout the school year. I understand that:

☐ I will receive advance notice of trips
☐ Specific permission will be requested for trips requiring extended travel, overnight stays, or special activities
☐ The information provided on this form will be used for all trips unless I provide updates
☐ I may opt out of individual trips by notifying the school

Medical information and emergency contacts from this form apply to all trips.

Parent/Guardian Signature: _________________________________ Date: _____________

This Field Trip Permission Form template is provided for informational purposes only and does not constitute legal advice. Consult with a qualified attorney in your jurisdiction before use. Liability releases signed by parents for minor children may have limited enforceability depending on state law.