Secondary School Student Trip Information and
Permission Form
Date
of trip: May 15, 2015
Destination:
Kings Dominion
Educational Objective(s):
To compete in the Kings Dominion Music Festival 2014
Departure time from
school: 7:30am
Return time: 8pm
Other
important information including: use of electronics, student dress, souvenir
shops, supplies needed:
See
information sheet
Keep the top half for your
information. Return the bottom half to
the appropriate teacher or staff member.
.
Please
list any serious allergies or medical
conditions of your child:
_______________________________________________________________________.
My child, ______________________________ has permission to attend
the trip to __Kings Dominion in Doswell, VA on ____May
15, 2015 .
I give prior permission for
any emergency medical treatment of my child where a delay could cause
significant harm to his or her health.
________________________________ __________
Parent/Guardian’s Signature Date
Parent
and Emergency Contact Name__________________________ or
__________________________
Phone
Numbers: ________________ or ___________________ or_______________
