{{ org_name }}
{{ org_tagline }}
Permission Slip
Field Trip
Authorization
Grade / Class
{{ grade_class }}
Trip Coordinator
{{ coordinator }}
Please return by
{{ return_by }}
1Trip Details
Destination
{{ destination }}  —  {{ destination_note }}
Date
{{ trip_date }}
Times
Bus departs school {{ depart_time }}  ·  Returns by {{ return_time }}
Transportation
{{ transportation }}
What to bring
{{ bring }}
Cost
{{ cost }}  —  {{ cost_note }}
2Parent / Guardian Consent
3Emergency Contact & Health Information
Emergency contact name
{{ ec_name }}
Relationship
{{ ec_relation }}
Best phone today
{{ ec_phone }}
Does your child have any allergies, medications, or medical conditions staff should know about?
No, none Yes — details: {{ health_details }}
4Signature
Parent / Guardian signature
Date
Printed name
Daytime phone
Detach & return the lower portion · keep the top for your records
{{ org_name_tear }} · {{ activity_short_tear }} — I give permission for my child to attend. $8 enclosed: Yes
Student name
Parent / Guardian signature
Date
{{ footer }}