Private Charter School Bus Trip Consent Form
Student Information
Student Name:
Grade:
Teacher/Homeroom:
Trip Details
Destination:
Date of Trip:
Departure Time:
Return Time:
Purpose of Trip:
Medical Information
Allergies or Medical Conditions:
Emergency Contact Name:
Emergency Contact Phone:
Consent and Release
By signing below, I give permission for my child to participate in the above school bus trip. I understand and accept that the school and its affiliates are not liable for unforeseen incidents.
Parent/Guardian Signature
Date