Student's Last Name, First Name Student Number
Bronx Preparatory Academy
Field Trip Permission Form
Destination of Trip: _________________________________________________
Sponsor of Trip: _______________________________
Date of Trip: _______________________ Time of Trip: _______ to ________
The above named student has my permission to attend the above named trip. It is my understanding that the cost of the trip will be $________ to cover __________________. If the time of the return is after school hours, I shall arrange to meet my child at the return time. I understand that I can call the Sheriff's office for information if the bus has not returned on time.
It is understood that the necessary precautions and plans for the care and supervision of the pupils during the trip will be strictly observed. I absolve the school and its representatives from any liabilities.
I have supplied the necessary medical and emergency information relating to this student.
To contact in case of emergency: ____________________________________
Telephone Number: _______________________
Medical conditions the supervisor should be aware of:
Parent/Guardian Signature Date
As a student attending this trip, I understand it is my responsibility to notify each of my teachers in advance of the trip and to make up all work I will miss within the teacher specified time frame. Further, I understand that if I fail to make up my work on time I will receive zeros for these assignments. I also understand that my behavior on this trip will determine my participation in future trips. I may not be allowed to attend this field trip if my grades are low in any class and this is at the discretion of each of my teachers.
Student Signature Date
As a teacher of the above named student, I am aware of this upcoming field trip...