KEYSTONE ELEMENTARY SCHOOL

Field Trip Permission Form

The 5 th Grade will be attending a fi eld trip
to:

The Cleveland Museum of Art

Tim
e

Date

Thursday, Nov. 19, 2015

Location

The Cleveland Museum of Art 11150 East Blvd, Cleveland, OH 44106

Cost

$6.50

Transportatio
n

School Bus

Notes

9:30 a.m. 1:30 p.m.

Reminder: All student fees must be paid prior to being permitted to attend school
fi eld trips.
Please bring a packed lunch, we will be eating in classrooms in the lower level of
CMA

Please return this permission slip

by:

Monday, November 16, 2015

I give permission for my

child

in room

to attend the fi eld trip

to

on

from

to

Enclosed is
$

to cover the cost of the trip. (Exact cash or check made payable to
school.)

In case of an emergency, I give permission for my child to receive medical treatment. In case of
such an emergency, please contact:
Name

Phon
e

Parent/Guardian
Signature

Date