Student's Name *

First Name

Last Name

Date of Field Trip *

MM

DD

YYYY

I give permission to Trinity School for my child to attend this field trip. In case of an accident or serious illness and the school personnel are unable to reach me, I hereby authorize the school to make whatever arrangements necessary to seek medical care. I do not hold Trinity Lutheran School, the staff or volunteers liable for accidents or injuries that may occur on this trip. Please indicate your knowledge and approval of this trip by providing your name and PIN

Yes

Please Call Me

Signature Date *

MM

DD

YYYY

Phone *

(###)

###

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