Field Trip Permission Form

Purpose: This form is used to collect authorization from a parent or legal guardian for a student to participate in school-organized field trips. It ensures parental awareness of trip details and acknowledges their approval for participation, travel, and emergency procedures.

Student Information

Student Name: {studentName}

Grade: {grade}

Teacher/Instructor: {teacherName}

Trip Details

Trip Name: {tripName}

Destination: {destination}

Date of Trip: {tripDate}

Departure Time: {departureTime}

Return Time: {returnTime}

Mode of Transportation: {transportation}

Cost (if any): {tripCost}

Chaperones

{#chaperones}

• {name} - {role}

{/chaperones}

Medical Information

Known Allergies: {allergies}

Medical Conditions: {medicalConditions}

Emergency Contact Name: {emergencyContactName}

Emergency Contact Phone: {emergencyContactPhone}

Insurance Information

{#hasInsurance}Insurance Provider: {insuranceProvider}
Policy Number: {insurancePolicyNumber}{/hasInsurance}

{^hasInsurance}No health insurance provided{/hasInsurance}

Parent/Guardian Consent

I, {guardianName}, am the legal parent/guardian of {studentName}, and I give permission for my child to participate in the school field trip described above.

I authorize school staff and chaperones to seek emergency medical treatment if necessary during this field trip. I understand that I will be contacted immediately in case of an emergency.

Signatures

Parent/Guardian Full Name: {guardianName}

Signature: _____________________________

Date: {signatureDate}