"Field Trip Parental Permission and Release Form - St. Gregory Hovsepian School" - California

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FIELD TRIP PARENTAL PERMISSION AND RELEASE FORM
My child
in
grade has my permission
Name of Child
to participate in a trip to
.
•Date:
Cost of the trip
: $
(Student)
•Time:
Cost of the trip
: $
(Participating Parent)
•Transportation
Drivers Needed:
Yes
No
Bus:
Yes
No
Private Cars:
Yes
No
PARENTS PLEASE NOTE:
 
California State Education Code, Section 35330 in part provides:
All persons making the field trip are deemed to have waived all claims against the school and its
employees and the State of California for injury, accident, illness, or death occurring during or by
reason of the field trip. If the field trip is outside the State of California, all adults participating in
the field trip and all parents or guardians of pupils taking the out of State field trip are required
to sign this statement waiving such claims.
Approval Signature of Parent/Guardian
Date
MEDICAL AUTHORIZATION
Should it be necessary for my child to have medical treatment while participating in this trip, I hereby
give the School personnel permission to use their judgment in obtaining medical service for the child
and I give permission to the physician selected by the School personnel to render medical treatment
deemed necessary and appropriate by the physician.
Student Name
Doctor's Name and Telephone No.
Emergency Telephone Numbers
Signature of Parent or Guardian
2215 East Colorado Boulevard • Pasadena, California 91107 • Phone: (626) 578-1343 • Fax: (626) 578-7378
FIELD TRIP PARENTAL PERMISSION AND RELEASE FORM
My child
in
grade has my permission
Name of Child
to participate in a trip to
.
•Date:
Cost of the trip
: $
(Student)
•Time:
Cost of the trip
: $
(Participating Parent)
•Transportation
Drivers Needed:
Yes
No
Bus:
Yes
No
Private Cars:
Yes
No
PARENTS PLEASE NOTE:
 
California State Education Code, Section 35330 in part provides:
All persons making the field trip are deemed to have waived all claims against the school and its
employees and the State of California for injury, accident, illness, or death occurring during or by
reason of the field trip. If the field trip is outside the State of California, all adults participating in
the field trip and all parents or guardians of pupils taking the out of State field trip are required
to sign this statement waiving such claims.
Approval Signature of Parent/Guardian
Date
MEDICAL AUTHORIZATION
Should it be necessary for my child to have medical treatment while participating in this trip, I hereby
give the School personnel permission to use their judgment in obtaining medical service for the child
and I give permission to the physician selected by the School personnel to render medical treatment
deemed necessary and appropriate by the physician.
Student Name
Doctor's Name and Telephone No.
Emergency Telephone Numbers
Signature of Parent or Guardian
2215 East Colorado Boulevard • Pasadena, California 91107 • Phone: (626) 578-1343 • Fax: (626) 578-7378