Children’s Activity Trip Transport Permission Slip

Participant Information

Child's Name

Date of Birth

Parent/Guardian Name

Contact Number

Trip Details

Activity/Trip Name

Date of Trip

Departure Time

Return Time

Location Method of Transport

Medical & Emergency Information

Medical Conditions/Allergies Emergency Contact Name Emergency Contact Number

Permission & Authorization

I hereby give permission for my child to participate in the above-named activity/trip and to be transported as necessary. I understand that all reasonable measures will be taken to ensure the safety and wellbeing of all participants.

Parent/Guardian Signature

Date