Environmental Clean-up Field Trip Consent Form

Student Information

Student Name: Grade: Teacher:

Trip Details

Date of Trip: Destination: Purpose of Trip:

Emergency Contact

Parent/Guardian Name: Phone Number: Email:

Medical Information

Medical Conditions/Allergies: Medications:

Consent

I give permission for my child to participate in the Environmental Clean-up Field Trip. In the event of an emergency, I authorize the supervising staff to seek medical attention as necessary.