Language Immersion Trip Permission Slip

Dear Parent/Guardian,
Your student has been invited to participate in a language immersion trip. Please review the details below and provide your consent.

Trip Information

Destination:

Dates of Trip:

Departure Time:

Return Time:

Teacher/Chaperone Name(s):

Contact Number(s):

Student Information

Student Name:

Grade:

Class/Teacher:

Medical & Emergency Information

Allergies or Health Concerns:

Emergency Contact Name:

Emergency Contact Phone:

Relationship to Student:

Permission & Acknowledgement

I understand the nature of this trip and give permission for my child to participate. In case of emergency, I authorize the supervising adults to seek medical care as needed.

Parent/Guardian Signature:

Date:

Please return this permission slip by: