HighSchoolFieldTripForm

FORT ATKINSON HIGH SCHOOL
FIELD TRIP PERMISSION AUTHORIZATION

S _______________________________________ has an opportunity to participate
(Student Name)

T in a field trip to _____________________________________________________
(destination)

U on ____________________________________. This trip is being sponsored by
(day/date)

E at ________________________ and will return by _________________________.
(time) (time)

N The cost of the trip is $ ____________________. If you have any questions, please
(amount)

T contact ________________________________________________.
(staff member)

RETURN THIS FORM BY ___________________________________________
(date)

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

P             My son / daughter has my permission to take part in this field trip. I also authorize school
           district employees to call for emergency assistance which could require the services of a doctor,
A       dentist or emergency vehicle (e.g. ambulance or rescue squad) .

R     ___________________________________        ____________________________
                                  (Parent Signature)                                                                                    (home phone number)
E
           _____________________________________________________              __________________________________________
N                                              (date)                                                                                           (work phone number)

T    * This form must be completed and returned to the person in charge of the field trip BEFORE the student may
               participate. These authorization forms shall be taken on the trip by the person in charge.

D ______________________________________ . The group will leave school
(class/group)

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

[email protected]

T                                                INSTRUCTOR
     HOUR          COURSE                INITIALS        YES    NO**         COMMENT/ASSIGNMENT
E      HR     ________________     ___________      YES     NO     ___________________________________
          1      ________________     ___________      YES     NO     ___________________________________
A        2      ________________     ___________      YES     NO     ___________________________________
          3      ________________     ___________      YES     NO     ___________________________________
C      4/5     ________________     ___________      YES     NO     ___________________________________
        5/6     ________________     ___________      YES     NO     ___________________________________
H      6/7     ________________     ___________      YES     NO     ___________________________________
        7/8     ________________     ___________      YES     NO     ___________________________________
E        9      ________________     ___________      YES     NO     ___________________________________
         10     ________________     ___________      YES     NO     ___________________________________
R       11     ________________     ___________      YES     NO     ___________________________________
                                    **NO -- teacher is expressing a concern that student should remain in class.

For further questions, ticket information, concert questions, etc., e-mail: