Farm Visit Field Trip Permission Form

Student Information

Student Name

Grade / Class

Teacher

Trip Information

Date of Trip Destination (Farm Name & Address) Departure Time Return Time

Emergency Contact

Parent/Guardian Name

Phone Number

Alternative Phone

Medical Information

Allergies / Medical Conditions Special Instructions

Permission and Agreement

I give permission for my child to attend the above field trip and authorize any necessary medical treatment in case of emergency.

Parent/Guardian Signature

Date