School Field Trip Media Waiver and Liability Form

Student Name Grade Teacher Field Trip Date Destination

Media Waiver

I authorize the school to take photographs, video, and/or audio recordings of my child during the field trip for educational, promotional, or informational purposes.

Yes No

Liability Waiver

I acknowledge that participation in the field trip may involve certain risks. I release and hold harmless the school, its employees, and agents from any liability, claims, or demands for injury, illness, or loss that may occur during the trip.

Medical Conditions or Allergies

Emergency Contact Name Emergency Contact Phone

Parent/Guardian Acknowledgment

Parent/Guardian Signature

Date