·        Field Trip Permission Form

TUSCALOOSA COUNTY BOARD OF EDUCATION

FIELD TRIP PARENTAL PERMISSION FORM

Tuscaloosa, Alabama******************************************************************SCHOOL/DEPARTMENT ________________________________________   DATE _______________________

 TO:                         Parent(s) or Guardian(s)

 FROM:                   Your Child’s Teacher/Coach/Sponsor

 A school activity has been planned away from the normal school premises. The specific information relative to the activity is listed below:

 MY CHILD’S NAME ____________________________________________________________________________

 PROPOSED SCHOOL ACTIVITY _________________________________________________________________

 NAME OF PERSON(S) IN CHARGE _______________________________________________________________

 DATE OF FIELD TRIP __________________________________________________________________________

 TRIP DESTINATION(S) _________________________________________________________________________

 DEPARTURE TIME ____________________            EXPECTED TIME OF RETURN ____________________

 COST TO YOUR CHILD ____________________ (Make any checks payable to the school)

 METHOD OF TRANSPORTATION:

SCHOOL SYSTEM BUS ______       COMMERCIAL CARRIER ______       PRIVATE VEHICLE ______       WALKING ______

 In case of an emergency, my child may ______ may not ______ receive medical treatment at the nearest emergency medical treatment facility. (Any emergency medical treatment shall be at the expense of the parent/guardian.)

 Provided you approve of your child making the trip based on the information provided above, please check the appropriate space below, sign your name in the space provided, and return this form by your child to the person(s) in charge. Provided you do not wish for your child to make the trip, please check in the appropriate space below and return the form unsigned by your child to the person(s) in charge.

 My child may ______ may not ______ participate in the above named activity.

 My child is covered by hospitalization/medical insurance.      ______YES    ______NO

 _____________________________________________________    ___________________________________

Parent/Guardian Signature                                                                                               Date

NOTE: Children will not be permitted to go on field trips without a signed Field Trip Parental Permission Form on file for each trip or associated series of trips such as football, basketball, etc.