Youth Program Field Trip Consent Form

Participant Information

Name of Youth Participant Date of Birth Address Parent/Guardian Name Parent/Guardian Phone Number Parent/Guardian Email

Field Trip Details

Trip Name/Destination Trip Date Meeting Location/Time

Medical Information

Allergies/Medical Conditions Medications Emergency Contact (if different) Emergency Phone

Consent & Authorization

I, the undersigned, give permission for my child to participate in the field trip outlined above and authorize emergency medical care if necessary.