School Field Trip Guardianship Permission Form
Student Information
Student Name
Grade/Class
Date of Birth
Teacher/Homeroom
Parent/Guardian Information
Parent/Guardian Name
Contact Number
Emergency Contact (if different)
Trip Details
Destination
Date of Trip
Purpose of Trip
Medical Information
Medical Conditions/Allergies
Medications
Permission & Authorization
I hereby give permission for my child to participate in the above field trip. I understand the activities and authorize the supervising school staff to obtain medical treatment in an emergency.
Parent/Guardian Signature
Date