Field Trip Permission Form

Dear Parent/Guardian,
Your child is going on a field trip. Please read the information at the top of this form,
then sign and return the permission slip at the bottom of this form by February 21, 2014
_____________.
Field trip information:
Date: ____February 28, 2014
_______________________________________________________________________
______________
Location: _____10044 s Bell Ave. Chicago Illinois
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_________
Purpose: ____Frog Farm
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Cost: _____$10:00 bring your own lunch
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Cash of Check Payable to: ___Cubbies Daycare
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Means of Transportation: ___School Bus
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Leave School: ____9:30 am____________________________ Arrive back at School:
2:00 pm. ______________________
Special Instructions: ______please be on time
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Save this part of the form for future reference
Cut Here -------------------------------------------------------------------------------------------------------------------------------------------Cut Here
__________________________________________________________ Has permission to attend a field trip to
__________________________________________
On _______________________________________________________ from ____________________________________ to
________________________________________.
Enclosed, please find cash/check in the amount of _______________________________________ to cover the cost of the trip. I give

Permission for __________________________________________________________ to receive emergency medical treatment. In an

emergency,
Please contact:
Name: ___________________________________________________________ Phone:
___________________________________________________________________
Parent/Guardian Signature: _________________________________________________________ Date:
_______________________________________________