DC Trip Payments - John Paul II Catholic High School

Student's Name*

Parent/Guardian Name*

Parent/Guardian Email Address*

2024 DC TRIP PERMISSION FORM & MEDICAL RELEASE
This field trip permission form & medical release includes the following:

Destination: Washington, D.C.
Date: May 1-3, 2024
Method of Transportation: Coach Bus
Teachers/Chaperones: JPII Faculty, Staff, and Parents

If you would like for your child to participate in this event, please sign the following statement of consent and liability. As parent, or legal guardian, you remain fully responsible for any legal responsibility that may result from personal actions taken by the named student.

I hereby consent to participation by my child in the event described above. I understand that this event will take place away from school grounds and that my child will be under the supervision of the designated school employee on the stated dates. I further consent to the conditions stated above on participation in this event, including the method of transportation.

Signature*

Date*

Signer Name*

Relationship to Student*

In case of emergency, I give permission for my child to be taken to a physician or hospital by either a parent or school personnel. I understand that every effort will be made to contact me.

The above-named student is covered by the following medical insurance:

Insurance Company*

Group/Policy Number*

Cell Phone Number of Parent/Guardian Who Signed Above*

If I cannot be reached, please contact:

Name*

Relationship*

Cell Phone*

Total